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Subject:
From:
Karen Gromada <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 26 Apr 2005 15:18:12 +0000
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Re: << Yes, I have expressed concern about a link between cabbage and listeria. I find this to be one area where lactation practice has not kept pace with research.
Research about cabbage has been clear for years that there is no documented advantage of cabbage over the use of cool gel packs…>>

I’m jumping in on this one as a cabbage “neutral” LC/LLLL. I tend to suggest cold packs and RPS as a first line of offense, although I’ve been known to suggest cabbage leaves (with instructions for washing well) in particular situations. And placebo effect is still a positive effect.

I think it’s going a bit too far to say the literature is “clear” re: cabbage leaves. When I reviewed the literature recently, the only thing that seemed clear is that there were few studies done. Those that were conducted appeared to lack large sample populations and/or well-controlled variables.


Re: << Listeriosis is a serious illness that comes most often from vegetables and other contaminated foods http://www.cdc.gov/ncidod/dbmd/diseaseinfo/listeriosis_g.htm )
Cabbage is one common carrier of listeria. >>


Also see http://www.vetmed.ucdavis.edu/PHR/phr150/2005/L._monocytogenes_4-2005.PDF for an update dated this month. It reviews outbreaks in the USA and Canada (and some other countries). Dairy and processed meats seem the biggest culprits in the USA. Cabbage-related outbreaks appear to be related to cole slaw, and there is the suggestion that the shredded cabbage may have been decomposing in a sealed container with some water. From what I’ve read, and in spite of the "cabbage leaves on breasts and potential for listeria" concern being raised years ago in our area, there has NEVER been a case of newborn/infant/child listeria associated with maternal use of cabbage leaves (washed or otherwise) on her breasts prior to breastfeeding. 

Considering how the press loves that stuff, I’d think we’d know of it if such had occurred.


Re: << Here's my thinking on the subject:
Because:
1) there is no demonstrated advantage of superiority of cabbage, and
2) cabbage is often a carrier of listeria, and
3) to remove listeria, cabbage would need a thorough washing, and ideally, cooking, and
4) women experiencing discomfort are unlikely to take the step of washing cabbage thoroughly (and putting cooked cabbage on the breast might be less soothing), and
5) the nipple is placed in the mouth of babies, thereby possibly transferring any listeria or other substance on the surface of cabbage leaves; therefore, I'm not comfortable making (or encouraging others to make) a recommendation of the use of cabbage for engorgement in breastfeeding mothers. 
Furthermore, women with any disturbance of the nipple/breast skin could theoretically contract listeriosis themselves through contact with contaminated cabbage leaves. >>

The above statements appear to me to be “listeria hysteria.” I understand Listeria m is a very serious disease, particularly in pregnant or newly delivered women or their newborns. I certainly would want to do nothing that is associated with its spread. But in the absence of even one case that can be attributed even remotely to cabbage leaves on the breast as a source of contamination for either an infant or its mother, I think we need to be careful over-reacting to a purely theoretical risk. (I appreciate that the author of the post clarified the above as her thinking/opinion vs. an evidence-based response on the subject.)


Re: << The other bottom line for me is that nursing the baby is the best "treatment" we have in our arsenal. Yet, lots of energy goes to pumping, ice, cabbage, etc, instead of getting the baby on the breast. >>

I must confess I don’t understand this comment. Is there someone suggesting cold packs, cabbage leaves, RPS, pumping, etc. INSTEAD of getting the baby to the breast? Most everyone I know pulls out these suggestions when the mother can’t get the infant onto the severely engorged breast…


Re: << I have not seen a published comment about the link between cabbage and listeria… >>

This is my bottom-line problem with this entire discussion. I have great respect for the LC who wrote this post and I respect her right to an opinion – as long as it was at the conference and remains labeled as her “opinion.” 

The research literature may lack strong support for cabbage leaves during severe breast engorgement, but there is no research/statistical data supporting cabbage leaves on the breast as a source of contamination for newborn or maternal listeria or a “ban” on the use of cabbage leaves. I dislike “fear tactics” and this is what the discussion on "listeria hysteria" seems to me to be.

Karen G.

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