I presume you are saying that mother cannot use cabbage due to allergy to
sulfa. I have immediate reaction to sulfa medicine but not to eating
cabbage or using topical cabbage. I don't think she needs to use the
cabbage, as there are other options, but she could test a small spot on her
skin to see if she reacts. I've seen several mothers who had sulfa allergy
but they could eat and use topical cabbage with no problems.

As to the severe engorgement, I would suggest very gentle and steady RPS in
an anti-gravity position, lying on her back, might have to use small
pillows to elevate the breasts if they are large and pendulous. I would try
the RPS frequently like every 1 to 2 hrs. I would not use the pump under
these circumstances (for now), since very little milk yield using it, but I
would try hand expression instead, after the anti-gravity RPS.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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