Breast engorgement is a common and often painful challenge many breastfeeding mothers face, especially in the early days postpartum. The discomfort can lead to frustration, making it difficult for mothers to continue their breastfeeding journey. While there are several approaches to managing engorgement, one natural remedy that has stood the test of time is the use of cabbage leaves.
Surprisingly simple yet effective, this age-old practice has been the subject of research studies aimed at understanding its benefits. In this post, we’ll explore the evidence behind using cabbage leaves for engorgement, how they work, and practical tips for incorporating them into lactation care.
Evidence Review
Application of Cold Compresses of Cabbage Leaves to Prevent Breast Swelling in Postpartum Maternal Nursing Care- Maharani & Nurhayati (2024)
This research found that using cold cabbage leaf compresses effectively reduced breast swelling and pain, especially within the first five days postpartum. The study highlighted the anti-inflammatory properties of cabbage, particularly due to compounds like sinigrin and sulfur, which help reduce fluid retention and inflammation.
The Effectiveness of Chilled Cabbage Leaf Application on Breast Engorgement: A Systematic Review- Maharani (2024)
The study demonstrated the effectiveness of using cabbage leaves to reduce breast swelling and pain among postpartum mothers. It concluded that cabbage leaves are an effective, low-cost solution for managing engorgement during the critical first postpartum week.
Effect of Cold Cabbage Leaf Application on Breast Engorgement and Pain in the Postpartum Period: A Systematic Review and Meta-Analysis- Ozkaya & Korukcu (2023)
This systematic review and meta-analysis assessed the effectiveness of cold cabbage leaves in managing breast engorgement and pain among postpartum mothers. The analysis included eight studies, revealing that while cold cabbage leaf applications significantly reduced breast pain, they did not show a statistically significant effect on reducing breast engorgement. The results indicated that cabbage leaves are effective in alleviating pain due to their anti-inflammatory properties, but more robust studies are needed to confirm their impact on engorgement. Despite mixed evidence on engorgement, cold cabbage leaves remain a popular non-pharmacological remedy due to their accessibility, low cost, and ease of use.
Common Complications of Breastfeeding and Lactation: An Overview for Clinicians- Radke (2022)
This overview mentions cabbage leaves as a popular remedy for engorgement, largely due to their cooling and soothing effects. However, it notes that while cabbage leaves can provide symptom relief, their long-term impact on breastfeeding outcomes remains unclear.
Application of Cabbage Leaves Compared to Gel Packs for Mothers with Breast Engorgement: Randomised Controlled Trial- Wong et al. (2017)
This study compared cold cabbage leaves to cold gel packs for relieving pain and breast hardness in postpartum women with engorgement. The results showed both methods were effective, with cabbage leaves slightly outperforming gel packs in reducing pain and hardness. The study concluded that cabbage leaves are a viable, accessible option for managing engorgement.
Treatments for Breast Engorgement During Lactation-Mangesi & Zakarija-Grkovic (2016)
This Cochrane systematic review analyzed various interventions for treating breast engorgement, including cabbage leaves. The review included three studies specifically examining the use of cabbage leaves. The results showed no significant difference between room-temperature cabbage leaves and chilled cabbage leaves, nor between chilled cabbage leaves and gel packs. While all interventions provided some relief, there was no evidence to suggest that cabbage leaves were more effective than other cold treatments. The review concluded that while cabbage leaves are commonly used, the evidence supporting their efficacy remains weak, with the quality of the studies being generally low.
A Comparison of Cabbage Leaves vs. Hot and Cold Compresses in the Treatment of Breast Engorgement- Arora et al. (2008)
The authors compared the effectiveness of cold cabbage leaves and alternate hot and cold compresses in managing breast engorgement among postpartum mothers. The results showed that both treatments were effective in reducing breast engorgement, but hot and cold compresses were superior in alleviating pain. While cold cabbage leaves and hot/cold compresses provided comparable relief for breast firmness, the compresses offered better pain relief. Therefore, cold cabbage leaves can be recommended as a simple, cost-effective option for managing engorgement, but for mothers experiencing significant pain, hot and cold compresses may be more beneficial. Lactation consultants can consider using a combination of both methods based on individual needs and preferences to optimize comfort and symptom relief.
Effects of Cabbage Leaf Extract on Breast Engorgement- Roberts et al. (1998)
This study investigated the effectiveness of cabbage leaf extract in alleviating breast engorgement among postpartum mothers. The findings demonstrated that applying cabbage leaf extract significantly reduced breast pain and discomfort compared to a control group. However, while cabbage leaf extract showed promise in relieving symptoms of pain, the study did not find strong evidence for a significant reduction in breast engorgement overall. The authors concluded that while cabbage leaf extract may offer temporary relief for pain, its impact on reducing engorgement is less clear, suggesting that further research is needed to confirm its efficacy in this area.
A Comparison of Chilled and Room Temperature Cabbage Leaves in Treating Breast Engorgement- Roberts et al. (1995)
This study compared the effectiveness of chilled cabbage leaves versus room temperature cabbage leaves in reducing breast engorgement among postpartum mothers. The results indicated that both chilled and room temperature cabbage leaves were effective in reducing breast pain and discomfort. However, chilled cabbage leaves provided slightly better relief in terms of pain reduction. Despite these benefits, there was no significant difference between the two methods in terms of reducing breast engorgement overall. The study concluded that while cabbage leaves, especially when chilled, may offer symptomatic relief for breast pain, their impact on actual engorgement reduction is limited.
A Comparison of Chilled Cabbage Leaves and Chilled Gelpaks in Reducing Breast Engorgement- Roberts (1995)
This study evaluated the effectiveness of chilled cabbage leaves versus chilled gel packs in alleviating breast engorgement among postpartum women. The results demonstrated that both interventions significantly reduced breast pain and discomfort associated with engorgement. However, there was no significant difference between the two methods in terms of reducing the overall severity of engorgement. Participants reported high satisfaction with both treatments, with some preference for cabbage leaves due to their natural and accessible nature. The study concluded that chilled cabbage leaves are as effective as gel packs for pain relief, making them a viable, low-cost option for postpartum mothers experiencing engorgement.
Consensus Statement on the Use of Cabbage Leaves for Breast Engorgement
The evidence regarding the efficacy of cabbage leaves for managing breast engorgement is mixed but generally supportive of their use as a non-pharmacological remedy for symptom relief. Multiple studies have shown that cold cabbage leaves can effectively reduce breast pain, likely due to their cooling and anti-inflammatory properties. However, the evidence on their ability to significantly reduce breast engorgement itself remains inconclusive, with some studies indicating no clear advantage over other cold treatments, such as gel packs or hot/cold compresses.
Most Recent, Evidence-Based Information
Recent systematic reviews and meta-analyses, including a 2023 review by Ozkaya and Korukcu, indicate that while cabbage leaves can reduce pain associated with engorgement, their impact on reducing breast swelling is less conclusive. The Cochrane review by Mangesi and Zakarija-Grkovic (2016) also supports the use of cabbage leaves for pain relief but highlights the need for higher-quality studies to establish their effectiveness in reducing engorgement. Despite these mixed findings, cabbage leaves remain popular due to their accessibility, low cost, and minimal side effects.
Takeaways for Lactation Consultants
- Non-Invasive Relief: Cold cabbage leaves can be recommended for mothers experiencing pain from breast engorgement as a safe, non-invasive, and cost-effective option.
- Application Guidelines: Advise mothers to apply chilled cabbage leaves for 20-30 minutes, ensuring they are thoroughly washed. This can be repeated a few times a day until symptoms improve.
- Temporary Pain Relief: Emphasize that cabbage leaves primarily offer symptomatic pain relief rather than addressing the root cause of engorgement. Encourage mothers to focus on frequent breastfeeding or pumping and proper latch techniques to manage engorgement effectively.
- Combination Approach: For mothers experiencing significant pain, consider combining cabbage leaves with other methods, such as hot and cold compresses, to optimize comfort.
- Patient Education: Inform mothers that while cabbage leaves are helpful for short-term relief, they should be used as part of a comprehensive lactation support plan to ensure sustained breastfeeding success.
References
Arora, S., Vatsa, M., & Dadhwal, V. (2008). A comparison of cold cabbage leaves and alternate hot and cold compresses in reducing breast engorgement. Indian Journal of Community Medicine, 33(3), 160-162. https://doi.org/10.4103/0970-0218.42057
Maharani, S. A. P., & Nurhayati, N. A. (2024). Application of cold compresses of cabbage leaves to prevent breast swelling in postpartum maternal nursing care day 1st to 5th day. Journal of Health Science and Nursing, 3(2), 30-32.
Ozkaya, M., & Korukcu, O. (2023). Effect of cold cabbage leaf application on breast engorgement and pain in the postpartum period: A systematic review and meta-analysis. Journal of Maternal and Child Health, 14(2), 215-222. https://doi.org/10.1177/2156587218822474
Radke, S. M. (2022). Common complications of breastfeeding and lactation: An overview for clinicians. Clinical Obstetrics and Gynecology, 65(3), 524-537.
Roberts, K. L. (1995). A comparison of chilled cabbage leaves and chilled gel packs in reducing breast engorgement. Journal of Human Lactation, 11(1), 17-20. https://doi.org/10.1177/089033449501100110
Roberts, K. L., Reiter, M., & Schuster, D. (1998). Effects of cabbage leaf extract on breast engorgement. Journal of Human Lactation, 14(3), 231-236. https://doi.org/10.1177/089033449801400315
Wong, B. B., Chan, Y. H., Leow, M. Q. H., Lu, Y., Chong, Y. S., & Koh, S. S. L. (2017). Application of cabbage leaves compared to gel packs for mothers with breast engorgement: A randomized controlled trial. International Journal of Nursing Studies, 76, 92-99. https://doi.org/10.1016/j.ijnurstu.2017.08.014
