Background: Milk deficiency is a common condition after delivery. Thai traditional medicine uses steamed ginger or hot herbal compress to promote milk production.

Objective: To investigate the efficacy and side effects of steamed ginger extract, hot herbal compress, and placebo for promoting milk production in normal first-time postpartum women at Thammasat University Hospital.

Materials and Methods: Standard quality values of the steamed ginger were investigated following the Thai Herbal Pharmacopoeia (THP) protocols. High performance liquid chromatography (HPLC) was used to identify the active constituents, which are 6-gingerol and 6-gingerol. The authors conducted an open, randomized, controlled trial with three groups. Ninety-nine women who had spontaneous vaginal deliveries were divided into three groups. One group received capsules of steamed ginger extract. Another group underwent hot herbal breast compresses, and a third group received capsules of placebo. All three interventions began two hours after delivery. Milk production was assessed using milk flow

rates (MFR) before intervention and at 12, 24, 36, and 48 hours postpartum.

Results: Ninety-nine woman were enrolled and 33 were in the steamed ginger group,33 in the hot herbal compress group, and 33 in the placebo group. They had similar baseline demographic, clinical, and laboratory characteristics. The steamed ginger powder used in the present research project passed all parameters according to THP volume II and was safe for the study. Phytochemical markers of steamed ginger extract, which contained 6-gingerol at 77.425±14.57 mg/g and 6-shogaol at 26.19±6.22 mg/g, respectively. Significant differences in MFR were observed between the right and left breasts at 36 and 48 hours after delivery across the steamed ginger, hot herbal compress, and placebo groups. For the right

breast, the flow rates at 36 and 48 hours postpartum were 2.67 and 3.18 for the steamed ginger group, 2.0 and 2.36 for the hot herbal compress group, and 1.88 and 2.27 for the placebo group. For the left breast, the flow rates at the same time points were 2.67 and 3.15 for the steamed ginger group, 1.97 and 2.42 for the hot herbal compress group, and 1.82 and 2.27 for the placebo group. These results were statistically significant (p<0.05). There was no adverse drug reactions reported in any of the three arms.

Conclusion: Steamed ginger can promote breast milk production 36 and 48 hours after delivery without adverse drug reactions.