The study is a cross-sectional study carried out at Marmara University Pendik Training and Research Hospital with breastfeeding volunteer mothers who applied to pediatric well child outpatient clinic. In order to carry out the study, ethics committee approval from Marmara University Faculty of Medicine Ethics Committee (Protocol No: 09.2018.057), institution permit from Ministry of Health Marmara University Pendik Education and Research Hospital and mothers' Informed Consent was obtained.
The questionnaire developed by the researchers was conducted in 2018 between 12 March and 30 June 2018. The study was carried out with mothers who consumed herbal tea containing galactagogue, who had a singleton pregnancy, fed only with human milk, and who started to breastfeed on the first postpartum day. Forty-three mothers who consume herbal tea containing galactagogue 3 cups per day (within the last 24 hours) and who give only human milk to their baby constituted the study group and 56 mothers who do not consume fenugreek or fenugreek extract, fennel extract, fennel oil, milk thistle or any nutrients or beverages which contain galactagogue constituted the control group.
Mothers who consumed herbal tea containing galactagogue, had a single pregnancy, fed their babies only with breast milk from the first postpartum day, did not use drugs or any nutritional supplements, did not smoke and alcohol, and signed a voluntary consent form were included in the study.
During the comparison of herbal tea type and breast milk content, herbal tea or herbal tea mixture specified by the mothers in 24-hour recall were used [20]. In the questionnaire form, the consumed teas and these content were questioned. Herbal tea mixture consumed by mothers belongs to a brand that mothers bought from the market. That mixture include sucrose, maltodextrin, roselle extract (%2.6), L-ascorbic acid (%0.5), raspberry leaf extract (%0.2), fennel extract (%0.2), fenugreek extract (%0.1), goat’s rue extract (%0.1) and fennel oil (%0.02) [21]. Cumin fennel and fennel herbal tea were bought and consumed by mothers from herbalist.
A questionnaire including questions such as demographic characteristics of the mothers, type of delivery, weight gain during pregnancy, time to start breastfeeding was applied by face-to-face interviews and 24-hour recall was recorded.
Four ml of mature human milk was obtained from all mothers and the analysis was repeated 2 times for the reliability of the results. After feeding the babies, the hind milk obtained by hand expression from the right breast was placed in Eppendorf tubes and analyzed with Miris® HMA (Human Milk Analyzer) TM in 2 hours on the 24-hour recall day. Protein, fat, carbohydrate and energy values were determined. Miris® HMA™ (Uppsala, Sweden) is approved by International Standards Organization (ISO) 9622: 1999.
Energy, macro nutrient intake of mothers' 24-hour recall were calculated by the BeBis program. The body weight and height of the mothers were measured according to the standards. Body weight was measured using the InBody 120 and height was measured using the stadiometer. The Body Mass Index (BMI) value was calculated by dividing body weight (kg) by the square of height (cm). For the evaluation of the results WHO's classification was used [22].
The data were evaluated statistically in SPSS (version 16.0.Ink) package program. Descriptive statistics include number, percentage, mean, and upper and lower values, as well as the standard deviation. Data were controlled by Kolmogorov Smirnov test for normal distribution. If data within the normal distribution Chi square test and T test for independent groups were performed. Chi-square test, Mann-Whitney U test and Kruskal-Wallis test were applied for the analysis of data which are not with normal distribution. Chi-Square test, Student's T test and One-Way ANOVA were used for multiple comparisons. Statistical significance of all analyzes was accepted as p < 0.05.