Aloe

Aloe vera gel consists of the clear gel from the center of fresh leaves of Aloe vera and related aloes. Active ingredients include mono- and polysaccharides (e.g., acemannan, glucomannan), allantoin, enzymes (e.g., cyclooxygenase, amylase, lipase, alkaline phosphatase, carboxypeptidase), and salicylic acid. It should not be confused with Aloe latex which comes from the inner portion of the skin and contains potent anthraquinone laxatives. Aloe vera gel has been used topically on the nipples during nursing to help heal cracked nipples. In a randomized, single-blinded study (investigators blinded), aloe vera was more effective than lanolin in decreasing nipple pain score after 7 days in women with sore nipples postpartum.[1] Another study compared breastmilk alone applied to the nipples after breastfeeding to either olive oil or aloe vera gel. All had less pain after 7 days of nursing, but the decrease on pain was greater with aloe vera than with the other treatments.[2] A third study found aloe vera to be superior to expressed breastmilk in decreasing nipple damage and pain and decreased nipple discharge after 10 and 14 days of therapy.[3] Topical aloe has also been combined with a cactus leaf preparation and massage to treat engorgement.[4] If aloe vera is applied to the nipples, it should be washed off before nursing the infant because the taste might adversely affect nursing or cause diarrhea in the infant.[5,6] Aloe vera gel has caused itching, burning, and allergic contact dermatitis, possibly from contamination with the irritating latex from the leaves.[7,8] Aloe vera gel also has an antiplatelet effect and can enhance the antiplatelet effect of other drugs. Aloe latex, the laxative, should not be used during breastfeeding.[9] Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to prove the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does not certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information about dietary supplements is available elsewhere on the LactMed Web site.