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.