Ayurvedic Milk Powder as a Health Drink—An Innovative Approach in Antenatal Health Care—A Research Proposal ^†

Abstract

Ayurvedic preceptors place much emphasis on nutrition, especially during antenatal and postnatal periods, which may reduce the likelihood of medical complications both during and after pregnancy. Classic Ayurvedic texts mention medicated milk as an important part of prenatal care for pregnant women. By evaluating the effects of the herbal drugs contained in these formulations, one can understand the pharmacodynamics of these products. The medicated milk, when converted into milk powder, represents a healthier alternative to malted milk powder.

1. Introduction

A healthy diet plays a significant role in pregnancy and lactation. An adequate and balanced diet can help to prevent prenatal complications and aid in the proper development of the fetus. The food taken by the mother is responsible for providing both the fetus and the mother with nutrition. In Ayurveda, antenatal as well as postnatal care are of paramount importance. Ayurveda emphasizes certain month-wise diet patterns and daily regimens for pregnant women, which are known as Māsānumāsika paricarya. Many Ayurvedic scholars provide detailed explanations regarding the month-by-month diet and regimen. These unique diet patterns reduce the risk of miscarriage early in pregnancy, improve fetal nutrition during the second trimester, and improve maternal health during the third trimester [1]. Sahasrayogam, a book about Ayurvedic treatments, mentions a particular drug used to prepare medicated milk every month [2]. Starting from the first month, medicated milk should be prepared with Sida cordifolia, Ipomea sepiaria, Solanum indicum, Desmodium gangeticum, Tinospora cordifolia, Solanum xanthocarpum, Hordeum vulgare, Chonemorpha macrophylla, Asparagus racemosus in the subsequent months.

2. Methodology

This study performs a review of the literature using authentic Ayurvedic textbooks and scientific articles in PubMed and Google Scholar. Databases were searched with the keywords Sida cordifolia, Ipomea sepiaria, Solanum indicum, Desmodium gangeticum, Tinospora cordifolia, Solanum xanthocarpum, Hordeum vulgare, Chonemorpha macrophylla, Asparagus racemosus separately, as well as these drugs AND Ayurveda, plus Ayurveda AND antenatal care. We selected articles based on both their title and content for relevance. While several review articles discussed the use of Ayurvedic milk during pregnancy, no clinical trials have looked directly at this issue. The effect of specific drugs on pregnancy has been studied in many preclinical and clinical trials.

3. Medicated Milk

Medicated milk, or Kṣīrapākā, is a unique Ayurvedic formulation in which milk is the basic component. Astringent or pungent drugs usually benefit from this method. It masks the bitter taste of drugs and reduces the intensity of pungent drugs. The therapy enhances the patient’s strength and endurance when they are fatigued from illness or other treatments. The preparation method of this medicine is more suitable for conditions requiring the use of fat-soluble ingredients [3]. Milk is often described as the best rejuvenator and is a commonly used drink from birth to death. Milk adds nutritional value along with the therapeutical effects of added drugs.

Drugs, milk, and water are boiled together at a specific ratio to prepare medicated milk. These are boiled in a mild fire until only the milk part remains. Different Ayurvedic preceptors have given different ratios of drugs, milk and, water for the preparation of the formulation. According to Śārangadhara samhita, the proportion of drugs, milk, and water is 1:8:32, and according to Yadavji Trikamji, the author of Dravyaguṇa, the ratio is 1:15:15. While explaining about laśuna Kṣīrapākā (medicated milk prepared with garlic), the author of Bhaiṣajya ratnāvali mentions the ratio as being 1:8:8 [4] (

Table 1. Ratio of ingredients.

SL. NO	Classical Reference	Ratio of Drugs:Milk:Water
1	Śārangadhara samhita	1:8:32
2	Dravyaguṇa	1:15:15
3	Bhaiṣajya ratnāvali	1:8:8

).

4. Month Wise Drugs for Medicated Milk

The drug mentioned in the first month of pregnancy is Sida cordifolia, which belongs to the Malvaceae family. As per Ayurveda, the drug has a sweet taste, low potency, and is classified as part of the madhura skandha (group of drugs with a sweet taste) and garbhasthāpana gaṇa (antiabortifacient drug). Pregnant women may experience tender swollen breasts, nausea with or without vomiting, and increased urination during the first month of pregnancy. The flavonoids found in Sida cordifolia support the anti-oxidant activity of this plant [5]. This antioxidant property prevents conditions such as spontaneous abortion, pre-eclampsia, fetal growth restriction, etc. [6]. A number of alkaloids present in Sida cordifolia have anti-inflammatory and analgesic properties [7]. It prevents backache and leg cramps. Pregnant women can also benefit from taking the herb to relieve frequent urination and high blood pressure during the first month of pregnancy.

The drug of choice for the second month of pregnancy is Ipomea sepiaria, a member of the Convolvulaceae family. Ayurvedic preceptors list the drug under garbhasthapāna gaṇa, and mentioned it as the most appropriate drug for the procedure of pumsavana (one of the 16 rituals in the ancient Indian concept). The antioxidant, analgesic and anti-inflammatory properties of Ipomea sepiaria make it useful in a variety of gynecological conditions.

During the fourth month of pregnancy, the most recommended drug is Desmodium gangeticum, belonging to the family Fabaceae. This herb possesses properties such as a bitter astringent taste, high potency, and is difficult to digest. It is indicated in a variety of conditions such as fever, vomiting, respiratory conditions, etc. The pterocarpanoids and gangetin it contains possess anti-inflammatory and analgesic properties [8]. The flavonoids and isoflavanoids glycosides in the drug provide the drug with significant antioxidant activity [9]. The nervous system of the fetus begins to develop during the fourth month, and the drug Desmodium gangeticum is found to have immense action in the central nervous system. The chemical components of Desmodium gangeticum can reduce constipation and emesis gravidarum symptoms.

In the third month of pregnancy, Solanum indicum, and in sixth month, Solanum xanthocarpum, both belonging to the Solanaceae family, are the preferred drugs. The most important chemicals in these herbs are saponins, glycosides, sesquiterpenoids, coumarins, etc. Solanum species are reputed for being potent antioxidants. They also prevent pregnancy-related hypertension and pedal edema.

During the fifth month of pregnancy, Tinospora cordifolia, belonging to the Menispermacea family, is the drug of choice. This drug is included under garbhasthāpana gaṇa. It is a drug rich in alkaloids, glycosides, steroids, polysaccharides, etc. It possesses a bitter astringent taste, low potency, is unctuous and is easy to digest. There are a wide range of conditions for which it is indicated, including diabetes, cardiovascular conditions, skin disorders, and rheumatic diseases. The effects of Tinospora cordifolia on oxidative stress in prenatal conditions have been studied extensively [10]. Its antidiabetic effect is contributed mainly by the tannins, alkaloids, flavonoids and saponins present in it. It also modulates the immunity of pregnant woman.

Pregnant women should consume milk prepared with Hordeum vulgare, a plant belonging to the Poaceae family, during the seventh month of pregnancy. It possesses a sweet astringent and bitter taste, and high potency. It is a good source of micronutrients as well as macronutrients. Ayurvedic preceptors mentioned it as a drug of choice in diabetes. Different pharmacological actions are possessed by it, such as antihypercholesterolemic activity, diuretic activity, fatty acid synthase inhibition, laxative effects, and lipid metabolism. A study of a fetus affected by maternal diabetes found that Hordeum vulgare actively stimulated the development of the fetal adrenal cortex [11]. In addition to promoting intestinal mobility, Hordeum vulgare is also effective in fostering lung growth in fetuses [12].

In the eighth month of pregnancy, most women use the drug Chonemorpha macrophylla, which belongs to the Apocynacea family. It possesses a bitter astringent sweet taste, high potency and is hard to digest. Chonemorpha macrophylla possessed skeletal muscle-relaxant action in an experimental model [13].

Asperagus racemosus, belonging to the Asperageacea family, is the drug of choice during the ninth month of pregnancy. It possesses a sweet bitter taste and low potency. Researchers have confirmed the galactogogue properties of Asperagus racemosus [14]. Furthermore, it increases vaginal dilation, which greatly facilitates vaginal delivery [15]. The list of drugs mentioned for preparing the medicated milk is mentioned below. (

Table 2. Month wise drugs for medicated milk.

SL. NO	Month	Drug	Botanical Name
1	First month	Balā	Sida cordifolia
2	Second month	Lakṣmaṇa	Ipomea sepiaria
3	Third month	Bruhatī	Solanum indicum
4	Fourth month	Amśumatī	Desmodium gangeticum
5	Fifth month	Guducī	Tinospora cordifolia
6	Sixth month	Nidigdhikā	Solanum xanthocarpum
7	Seventh month	Yava	Hordeum vulgare
8	Eighth month	Moraṭa	Chonemorpha macrophylla
9	Ninth month	Śatāvarī	Asperagus racemosus

).

5. Medicated Milk Powder

Medicated milk is a type of decoction (kwātha kalpana), the shelf life of which is one day. Procuring small quantities of raw drugs from the market and preparing the medicated milk each time is a tedious process. It is possible to prepare medicated milk powder without experiencing this problem using a spray dryer. A spray dryer rapidly dries a liquid from a slurry or liquid by adding hot air to the liquid or slurry [16]. Medicated milk powder preparation requires care. The quality of the prepared powder must be assessed before packing.

6. Conclusions

Ayurvedic milk powder serves as a healthier alternative to commercial malted milk powder, as it ensures the well-being of the mother and baby. Ayurvedic milk powder may help to reduce the risks and complications associated with pregnancy when associated with normal antenatal care. This new dosage form should undergo extensive preclinical and clinical trials before being introduced to the market.