Hi, I'm Pearl Shifer, M.Ed, IBCLC, Breastfeeding Coordinator at a WIC program
in NYC.
I've been following the articles in JHL regarding cabbage leaves as a
treatment for initial engorgement.  According to Chloe Fisher in
"Bestfeeding", using cabbage leaves is a folk remedy, among other folk
remedies that she discusses.  Valerie Ann Worwood, in her book "The Complete
Book of Essential Oils and Aromatherapy"  also writes about using cabbage
leaves in treating various ailments. She recommends ironing, yes, ironing,
the cabbage leaf first to release the enzymes that are going to do the
healing work, and to apply the leaf while hot.  She doesn't talk about this
in reference to engorgement, but I think that if we are going to use this
remedy, we might ask the mother to iron the leaf first. I also have read that
pounding the leaf first releases the juices as well, although I can't find
the reference for that.  When I do, I'll be happy to post it. The studies in
JHL talked about chilling the leaf first; of course, ironing (or pounding)
the leaf is doing something  that might actually show differences between
cabbage and gelpacks!

 Diane Stein, in " The Natural Remedy Book for Women" also talks about using
cabbage poultices for various dis-eases.  I recommend both these books for a
fascinating look at alternative treatments for common ailments.