Cabbage Leaves for Treatment and Prevention of Breast Engorgement
Sandra Smith, MPH CHES
BackgroundThis review was conducted as part of the annual review and updating of Beginnings: A Practical Guide Through Your Pregnancy (3rd edition (1997) Findings are reflected in the 1999 edition. Prior to review, Beginnings recommends in Book 6, page 61 the following for relief of breast engorgement:
- Put ice packs on your breasts
- Do not touch your nipples or let clothes rub on them
- Do not squeeze out the milk
- In the shower, do not let hot water flow directly on your breasts.
While this is still sound advice, ice packs can be quite uncomfortable. Nursing mothers should be comfortable touching their breasts. Mothers will naturally notice and avoid the discomfort of clothes that rub and hot water in the shower. Therefore, for this 1998 update, we sought a method of proactive self-care for breast engorgement.
Many perinatal nurses, lactation specialists and midwives recommend cabbage leaves applied to the breast to relieve pain of engorgement. A review of literature indicates this is a long standing treatment. Although relatively little formal research has been reported, the evidence base is convincing.
The Cochrane Pregnancy and Childbirth group maintains a registry of randomized and quasi-randomized clinical trials. Two researchers searched the Cochrane database and located one trial of cabbage leaves used for breast engorgement (Birth 20:2 June 1993). A control group received routine breast care. The experimental group used cabbage leaves and reported less breast engorgement than controls, but the trend did not reach statistical significance.
At six weeks the group using cabbage leaves was more likely to be breast feeding exclusively (p = .09) and their mean duration of exclusive breast feeding was significantly longer than controls (p = .04). Reviewers conclude that use of cabbage leaves resulted in fewer women giving up breast feeding. They recommend further research into effects of using cabbage leaves to prevent or treat engorgement since the mechanism by which the leaves produce beneficial effects remains unclear.
Lees suggests that sulfur in amino acid methionine acts as an antibiotic and anti-irritant, which in turn draws an extra flow of blood to the area. This dilates the capillaries and acts as a counter irritant, thus relieving the engorgement and inflammation and allowing milk to flow freely.
Roberts, Reiter and Schuster found significantly less pain with both chilled and room temperature cabbage leaves. They conclude it is not necessary to chill leaves before use.
Based on this scientific evidence that cabbage leaves may reduce pain of engorgement without side-effects, and that use of cabbage leaves increases breastfeeding duration, plus a large body of anecdotal evidence from numerous nursing and midwifery experts, Beginnings will recommend use of cabbage leaves for engorgement. In addition, the advice to avoid squeezing out milk will be retained since this tends to increase milk supply and cause engorgement to persist.
Renfrew, MJ. and Lang, S. Full text available from the Cochrane Database. Study reviewed is Nikodem, Danzinger et al. (1993) Do cabbage leaves prevent breast engorgement? A randomized, controlled study Birth 20:2.
Roberts KL, Reiter M, Schuster D. (1995) A comparison of chilled and room temperature cabbage leaves in treating breast engorgement. Journal of Human Lactation 11(3): 191-4.
Lees, M. Cabbage Leaves for Engorgement, online at http://www.gentlebirth.org/archives/bestfeed.html#Engorgement
Roberts, Kathryn: A comparison of chilled cabbage leaves and chilled gelpacks in reducing breast engorgement. Journal of Human Lactation 11(1), 1995; 17-20
Rosier, Wendy: Cool cabbage compress. Breastfeeding Review 1988; 12:28-31
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