I guess I'm the devil's advocate on the cabbage front.  I hope no one is
personally offended by my thoughts about cabbage -- I really have nothing
against this cruciferous vegetable, which will certainly be a popular
grocery item this week, at least in the US, for St. Patrick's Day corn beef
& cabbage dinners.

Kathleen quotes Lawrence: "Cabbage is noted to contain sinigrin (allyl
isothiocyanate) and rapine. Herbalists consider rapine to be an antifungal
antibiotic."

I was unable to find any health-associated claims for sinigrin - just
flavor claims: "Sinigrin, a sulfur compound present in cabbage, is broken
down by myrosinase to produce a mustard oil called allyl isothiocyanate, a
sharp, pungent flavor."  Hmmm.. could this sharp, pungent flavor dissuade
babies from latching on to a cabbage treated breast?

The potential effect of rapine as an antifungal antibiotic is intersting,
but doesn't indicate any anti-engorgement effect.

Supposing that these chemicals, or some other of the hundreds in cabbage,
might have an anti-engorgement effect, more questions come up in my mind:
1) Do we know if these chemicals can be absorbed transdermally?
2) If they are absorbed transdermally, are there any side-effects of their
presence in breast milk that should concern us?

Regarding Jan's statement that there is no evidence that cabbage is
harmful, I recall Assunta Osterholt, IBCLC's  post last year stating that
she had discovered that cabbage can carry listeria.  Remembering that
cabbages grow in potentially contaminated soil, we could potentially
introduce microbes and other chemicals via cabbage directly on the breast.

Jan writes further: "If I had the time...I would do a study to replicate
the work cited in the original article written in 1987 by Wendy Rosier . . "

Wendy Rosier's work is a collection of case reports.  Case reports
constitute the lowest form of evidence, as categorized in the generally
accepted "Hierarchy of Evidence" (level 7: Case reports); and in the coding
system used in the ILCA Evidence-Based Guidelines book (Code III - Opinions
of respected authorities, based on clinical experience, descriptive studies
and case reports, or reports of expert committees).  Case reports are very
important, as they open the field to interest in research.  However, they
are not randomized or controlled in any way.  One would not replicate a
case study, but design a randomized controlled protocol to test the
suspected effect.

Certainly, more research regarding cabbage will help to elucidate any
potential benefit or harm of its use.

Regards to all,
Cindy


Cindy Turner-Maffei, MA, IBCLC
Massachusetts, USA

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