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Subject:
From:
"Hoover, Janet (DSCH)" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 4 Feb 2004 14:08:30 -0800
Content-Type:
text/plain
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Here is the abstract for the Cochrane Review on breast engorgement.
http://212.49.218.202/abstracts/ab000046.htm
<http://212.49.218.202/abstracts/ab000046.htm>
Is anyone using/recommending trypsin/ bromelian compound? What about Danzen
(serrapeptase)? Here is a link to the study on Danzen. (
http://healingtools.tripod.com/serrapeptase.html
<http://healingtools.tripod.com/serrapeptase.html> .

And can anyone explain reducing salt intake. I have always told edematous
women NOT to restrict salt. I had heard that restricting salt causes fluid
retention in order to maintain sodium levels. What is the current thinking?

Thanks!

Janet Hoover, LM, IBCLC
Lactation Consultant
Dominican Hospital
Santa Cruz, CA

mailto:[log in to unmask] <mailto:[log in to unmask]>


From The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons,
Ltd. All rights reserved.



Treatments for breast engorgement during lactation (Cochrane Review)


Snowden HM, Renfrew MJ, Woolridge MW


ABSTRACT


<http://www.update-software.com/DocDeliv/logon.asp?SourceID=CD000046&Languag
eID=EN&Version=0> Order full review

<http://www.update-software.com/scripts/ccng/ccng.exe?Action=ShowDoc&Content
=Yes&SourceID=CD000046> View and/or submit comments
 <http://212.49.218.202/abstracts/newreviews.htm> What's new in this issue

 <http://www.update-software.com/cochrane/abstract.htm> Search abstracts

 <http://212.49.218.202/abstracts/mainIndex.htm> Browse alphabetical list of
titles
 <http://212.49.218.202/abstracts/crgindex.htm> Browse by Review Group
  _____


A substantive amendment to this systematic review was last made on 09
February 2001. Cochrane reviews are regularly checked and updated if
necessary.

Background: National surveys have shown that painful breasts are the second
most common reason for giving up breastfeeding in the first two weeks after
birth in the UK. One factor contributing to such pain can be breast
engorgement. Views differ as to how engorgement arises, although restrictive
feeding patterns in hospital are likely to have contributed in the past.
These differing views are reflected in the range of solutions offered to
treat engorgement in breastfeeding mothers and these treatments are assessed
in this review.

Objectives: To determine the effects of any proposed intervention to relieve
symptoms of breast engorgement among breastfeeding women.

Search strategy: The register of clinical trials maintained and updated by
the Cochrane Pregnancy and Childbirth Group. CINAHL and MEDLINE were also
searched. Date of last search: December 2000.

Selection criteria: All randomised and 'quasi-randomised' controlled trials,
with or without blinding, that assess the effectiveness of treatments for
the alleviation of symptoms in breastfeeding women experiencing engorgement
.

Data collection and analysis: Data were extracted by one reviewer and
verified by a second reviewer.

Main results: Eight trials, involving 424 women, were included. Three
different studies were identified which used cabbage leaves or cabbage leaf
extracts;. no overall benefit was found. Ultrasound treatment and placebo
were equally effective. Use of Danzen (an anti-inflammatory agent)
significantly improved the total symptoms of engorgement when compared to
placebo (odds ratio (OR) 3.6, 95% confidence interval (CI) 1.3 - 10.3) as
did bromelain/trypsin complex (OR 8.02, 95% CI 2.8-23.3). Oxytocin and cold
packs had no demonstrable effect on engorgement symptoms.

Reviewers' conclusions: Cabbage leaves and gel packs were equally effective
in the treatment of engorgement. Since both cabbage extract and placebo
cream were equally effective, the alleviation in symptoms may be brought
about by other factors, such as breast massage. Ultrasound treatment is
equally effective with or without the ultra-wave emitting crystal, therefore
its effectiveness is more likely to be due to the effect of radiant heat or
massage. Pharmacologically, oxytocin was not an effective engorgement
treatment while Danzen and bromelain/trypsin complex significantly improved
the symptoms of engorgement. Initial prevention of breast engorgement should
remain the key priority.

Citation: Snowden HM, Renfrew MJ, Woolridge MW. Treatments for breast
engorgement during lactation (Cochrane Review). In: The Cochrane Library,
Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.



  _____


This is an abstract of a regularly updated, systematic review prepared and
maintained by the Cochrane Collaboration. The full text of the review is
available in The Cochrane Library (ISSN 1464-780X).





The Cochrane Library is designed and produced by
<http://www.update-software.com/> Update Software Ltd, and published by John
Wiley & Sons Ltd.




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