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<li>In the article, Breastfeeding assessment protocol: An integrated approach<ref name="ref28"></ref> the authors have extensively described the breast feeding protocol and assessment to ensure the health of newborn and lactating mothers. This can also be used as reference for further studies.</li>
<li>In the article, Breastfeeding assessment protocol: An integrated approach<ref name="ref28"></ref> the authors have extensively described the breast feeding protocol and assessment to ensure the health of newborn and lactating mothers. This can also be used as reference for further studies.</li>
<li>In the study, An Ayurvedic Review on Phakka Roga w.s.r. To Rickets in children<ref name="ref29"></ref> the detail analysis of Phakka Roga as a consequence of Stanya Dushti leading to nutritional deficiency like rickets is done in the present article.</li></ol>
<li>In the study, An Ayurvedic Review on Phakka Roga w.s.r. To Rickets in children<ref name="ref29"></ref> the detail analysis of Phakka Roga as a consequence of Stanya Dushti leading to nutritional deficiency like rickets is done in the present article.</li></ol>
== Herbal drugs for nourishment of stanya ==
<ol style="text-align:justify;"><li>Many herbal galactogogues have like Shatavari (Wild Asparagus) and Ashwagandha (Withanina) are extensively studied in contemporary sciences as well. Various systematic reviews are done to generate bulk data regarding the same.<ref name="ref30"></ref><ref name="ref31"></ref></li>
<li>Similarly extensive studies have been done on the evaluation of the galactogue potential of single herb like Musta (Cyperus rotundus)etc. Preclinical study entitled as “The Evaluation of a lactogenic activity of an aqueous extract of Cyperus rotundus Linn”<ref name="ref32"></ref> revealed that the the aqueous extract of Cyperus rotundus can stimulate milk production in the female rats. </li>
<li>The article, The Potential of Medicinal Plants as Galactagogue in Indonesia: A Review from Medical Perspective the ethnobotanical review galactagogue effect and breast milk promoting effect of different herbs native to Indonesia is elaborated.<ref name="ref33"></ref></li>
<li>The study “ Botanical galactogogues: nutritional values and therapeutic potentials” focuses on the nutritional and therapeutic effect of selective herbal plants from the family like Verbenaceae, Bignoniaceae, Sapindaceae, Amaranthaceae, Asclepiadaceae, Bombacaceae, Sapindaceae, and Asteraceae.<ref name="ref34"></ref></li></ol>
== Clinical Studies considering the aspects of stanya ==
<ol style="text-align:justify;"><li>The article “Clinical Study on Plant Galactagogue Worldwide in Promoting Women’s Lactation: a Scoping Review<ref name="ref35"></ref>”, is a systematic review on the different herbs analysed for their clinical galactagogic activity.</li>
<li>The article, A Double-Blind Randomized Clinical Trial for Evaluation of Galactogogue Activity of Asparagus racemosus Willd.<ref name="ref36"></ref> is a randomized double-blind clinical trial evaluates galactogogue effect of Shatavari in 60 lactating mothers by evaluating their prolactin hormone level during the study.</li>
<li>The article, Stanyakshya (insufficient lactation) and its management by an Ayurveda formulation: A case report<ref name="ref37"></ref> mentions the positive effect Kwath prepared with Shatapushpa, Dhanyaka, Jeeraka, Methi used traditionally in Rajasthan which was administered in women with insufficient lactation. This intervention showed encouraging results. </li>
<li>In the research study, To Evaluate the efficacy of Aahara –Vihara on Stanya Kshaya in Healthy Female Volunteers of different Deha Prakriti<ref name="ref38"></ref> the effect of dietary and lifestyle intervention on Stanya Kshaya is explored. The study included the dietary interventions in women of Stanya Kshaya. Most of the women were of Vata-Kapha Prakriti and dietary interventions showed benefit in their condition.</li>
<li>The efficacy of different Gana mentioned in the management of Stanya Kshaya is also assessed clinically. For instance, the article, Haridradi Gana Kwatha in the Management of Stanya Kshaya w.s.r To Hypogalactia - A Clinical Study<ref name="ref39"></ref> depicted that the Haridradi Gana kwatha has promising results in the management of all the parameters of Stanya Kshaya. </li>
<li>The study entitled. A Comparative study of Madhuk Churna with Vidarikanda Churna in the management of Stanyakshaya<ref name="ref40"></ref> showed encouraging results in management of Stanya Kshaya. The authors have compiled the different Stanyajanana herbs in Bhavaprakash Nighantu</li>
<li>The article, Role of Stanyashchotan (topical application of Breast milk) in Opthalmia Neonatorum - a case study<ref name="ref41"></ref> discusses the pharmacological effect of topical application of Stanya in condition of Opthalmia Neonatarum leading to significant relief in symptoms.</li></ol>
== Contemporary approach ==
=== Physiology of Lactation- ===
<p style="text-align:justify;">The initial growth of mammary glands starts with thelarche at puberty while the duct system and glandular tissue develops for the production of milk just before gestation under the influence of hormones estrogen and progesterone. Prolactin is necessary for milk secretion and proliferarion of epithelial cells of mammary alveoli. Thus the physiological aspects related to initiation of milk secretion (lactogenesis) and maintenance of milk secretion (galactopoiesis) is dependant on hormones via hypothalamo-pituitary axis. Milk ejection is dependant on suckling by the infant and is a neuro-endocrine reflex initiated via the oxytocin.<ref name="ref42"></ref></p>
=== Composition of Breast Milk ===
<p style="text-align:justify;">Human milk forms the primary source of nutrition for infants. It contains about 88.5% of water and 11.5% of solids. The breast milk secreted before parturition and in initial post natal period is termed as colostrum at rate of 40ml a day. It also contains lactose, lactalabumin, iron, Vitamin A and D and minerals. It also contains several antibodies (Immunoglobulins- IgA), phagocytes, macrophages important for the protection of infants from microbial attack.<ref name="ref43"></ref> The colostrum contains low fat content but more protein. During the 2<sup>nd</sup> and 3<sup>rd</sup> weeks after birth there is change in composition of breast milk where it becomes rich in fats and sugars and its calorific value also increases. This is termed as transitional milk. By the time baby is 3 weeks old, the milk attains mature composition making it high in fats, sugars, essential amino acids, is iso-osmotic with plasma with high calorific value.<ref name="ref44"></ref> The composition of human breast milk can be expressed in table as given below (Table No. 4)-</p>