Which Benefits and Harms of Using Fenugreek as a Galactogogue Need to Be Discussed during Clinical Consultations? A Delphi Study among Breastfeeding Women, Gynecologists, Pediatricians, Family Physicians, Lactation Consultants, and Pharmacists

Table 3

Potential harms of using fenugreek to enhance human milk supply that need to be communicated to and discussed with breastfeeding women during the clinical consultation.

Item #	Potential harms	Round on which consensus was achieved
		Panel of healthcare providers	Panel of women
	Fenugreek has anticoagulant effects
1	Breastfeeding women who have a history of any clotting related disorder need to be warned not to take fenugreek	2	1
2	Breastfeeding women who have a history of vaginal bleeding disorder need to be warned not to take fenugreek	1	1
3	Breastfeeding women who are at risk of any bleeding disorder need to be warned not to take fenugreek	1	1
4	Breastfeeding women need to be warned that fenugreek might be associated with menstrual breakthrough bleeding	2	1
5	Breastfeeding women who are on anticoagulants need to be warned not to take fenugreek	2	1
6	Breastfeeding women who are on non-steroidal anti-inflammatory drugs (NSAIDs) need to be warned not to take fenugreek	2	1
	Fenugreek might be associated with abortion
7	Women planning to become pregnant need to be warned that fenugreek is a potential utero-stimulant and might cause spontaneous abortion	2	2
8	Women with a history of previous miscarriage need to be warned not to take fenugreek	1	1
9	Women planning to become pregnant need to be warned that fenugreek might impair fetal development	1	1
	Risks associated with using fenugreek on other co-morbidities
10	Breastfeeding women need to be warned that fenugreek might cause nausea and vomiting	2	2
11	Breastfeeding women need to be warned that fenugreek might cause diarrhea in the mother and her breastfed infant	2	1
12	Breastfeeding women with a history of asthma need to be warned that fenugreek might worsen the symptoms of their asthma	1	1
13	Breastfeeding women need to be warned that fenugreek might cause dehydration	1	1
	Fenugreek could be associated with hypotension
14	Breastfeeding women with a history of or at risk of hypotension need to be warned not to take fenugreek	1	1
15	Breastfeeding women with a history of or at risk of dizziness need to be warned not to take fenugreek	2	1
16	Breastfeeding women who are on anti-hypertensive medications need to be warned not to take fenugreek	1	1
	Fenugreek could be associated with hypoglycemia
17	Breastfeeding women with a history of or at risk of hypoglycemia need to be warned not to take fenugreek	2	1
18	Diabetic breastfeeding women whose disease is controlled by medications or insulin need to be warned not to take fenugreek	1	1
	Other adverse effects
19	Breastfeeding women need to be warned that fenugreek might cause fever	2	1
20	Breastfeeding women need to be warned that fenugreek might cause excessive sweating	2	2
21	Breastfeeding women taking diuretics, laxatives, mineralocorticoids, and/or other hypokalemic agents need to be warned that fenugreek may worsen hypokalemia	2	1