Last week Ruth Scuderi, IBCLC posted some references concerning whether or
not cabbage leaves prevent breast engorgement. Of these references, the most
current one was written in 1995. This got me wondering if there were any
more recent studies or more recent information out there. My name is Laura
Birk and I am a student nurse at the University of North Dakota in the
second semester of my Junior year.
In reviewing the literature (mainly journal articles), the more recently
written articles kept referring to the studies done by Roberts in 1995 that
was included on Scuderi's list. In these studies, Roberts (1995) compared
the effects of chilled cabbage leaves to the effects of chilled gel packs on
self-reported pain of engorgement and found that while both resulted in a
statistically significant reduced amount of reported pain, most women
preferred the application of cabbage leaves. In 1998, Roberts compared the
effects of a cream containing a potential chemical from the cabbage
responsible for the treatment of engorgement to a placebo cream. The results
showed that mothers perceived both creams had equal effect. Neither had any
effect on the chest circumference, however, the creams did have an effect on
breast hardness. ( Roberts, Reiter, & Schuster).
In response to these studies, a letter to the editor of the Journal of Human
Lactation written by Linda Caplan, RN, MS, IBCLC, stated a question of why
were researchers looking for some "elusive" chemical in the cabbage leaves.
She suggested that the drawing action of the cabbage leaves be looked at
instead. She gave an example of how she placed different cabbage leaves in
red-colored and blue-colored water with only 2 inches of the leaf being
cover. What resulted was that the entire leaf turned the color of the water.
(Caplan, 1999) No further studies directed at this line of hypotheses could
be found.
This leaves us (no pun intended) with the question of are cabbage leaves the
best effective treatment of breast engorgement, no matter how they work? A
continual review of the treatments of breast engorgement is written by the
Cochrane Library. The most recent addition discusses that only two studies
have shown a direct effect of the intervention tested on treating the
symptoms of engorgement. These interventions were using protease complex and
using Danzen. It also mentions that the studies using cabbage leaves could
not rule out the possibility of a placebo effect and that the use of
oxytocin, ultrasound, or cold packs "has no basis in the treatment of
engorgement" (Snowden, Renfrew, & Woolridge, 2002).
What have any of you seen in your own practice and/or what do you suggest to
your clients/patients? For those of you suggesting cabbage leaves, have any
of your clients/patients raved of its therapeutic effects?
References:
Caplan, L. (1999). Drawing action of cabbage leaves. Journal of Human
Lactation, 15, 7-8.
Roberts, KL. (1995). A comparison of chilled cabbage leaves and chilled
gelpaks in reducing breast engorgement. Journal of Human Lactation, 11,
17-20.
Roberts, KL., Reiter M., & Schuster, D. (1998). Effects of cabbage leaf
extract on breast engorgement. Journal of Human Lactation, 14, 231-235.
Snowden,HM., Renfrew, MJ., & Woolridge, MW. (2002). Treatment for breast
engorgement during lactation. Cochrane Library [Electronic version], 1-8.
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