Supporting Breastfeeding

La Leche League Canada

Engorgement: Cabbage leaves and Other Treatments

on February 29, 2016

Engorgement is the tender, full, larger feeling that many women get in their breasts between day 2 and day 6 after giving birth.  Some women describe it as feeling like they have Barbie Doll breasts.  The change in size and sensation is caused by increasing milk volume and increased blood and lymph flow to the breasts.  The increase blood and lymph flow supports milk production.

Women who have had intravenous fluids during labour are at an increased risk of having an extended period of engorgement while the body rids itself of the excess fluids.  If the baby is latching and nursing well the normal postpartum levels of extra fluid generally don’t cause any breastfeeding difficulties.  As the pregnancy and childbirth hormone levels decrease over
the next few weeks, mother’s breasts feel softer in-spite of the increased milk volume of established breastfeeding.

Several studies have shown that when babies feed more frequently in the early days mothers are less likely to experience engorgement.  An Australian study which compared mothers who were told to let their babies nurse as long as their wanted on one breast before offering the second breast found those mothers had less engorgement than the mothers who were told to be sure their babies took both breasts at a feeding.

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Treatments for postpartum breast engorgement have not been well studied so mothers will get lots of opinions and advice.  The ideas we know work well are those that get the baby nursing effectively and emptying the breast:

-Breastfed as often as baby is willing (at least every 2-3 hours) and allow the baby to stay on the first breast until he comes off on his own.  The second breast can be offered if the baby is interested.  If baby isn’t interested in the second breast right away make sure to offer that side at the next feeding whether that is 10 minutes or two hours later.

– Get assistance sooner rather than later from La Leche League or another trained breastfeeding support person if baby is not latching well.

– Cold compresses between feedings can help reduce the swelling and the often feel good.  A soft gel Ice packs or a bag of small dice frozen vegetables works well to sooth an engorged breast.  Protect the skin with a layer of cloth between the ice pack and the skin.

– Pain medication may be helpful while waiting for the increased breastfeeding and cold compress to be effective if a mother is experiencing a lot of discomfort from engorgement. Discuss appropriate pain control medication with a health care provider.

– Express some milk if baby isn’t able to latch on well due to the swelling.  Some mothers worry that by expressing milk they will increase their milk production and create a bigger problem. Draining the breast helps to decrease the congestion of extra blood and lymph in the breast tissues.  Milk volume is unlikely to increase beyond baby’s needs with the amount of milk expression needed to regain comfort and make it easier for baby to latch on.

– Gentle breast massage before feeding or expressing may help to make the milk flow more easily.

-Cabbage leaves have long been recommended as a treatment for engorgement.  The small amount of research that has been done shows they don’t prevent engorgement.  Another study showed that they don’t appear to be any more effective than frozen gel packs but mothers preferred using cabbage leaves over the frozen gel packs.  If mothers want to try using cabbage leaves as a treatment for engorgement, choose green cabbage not the red/purple variety (it stains skin and clothing!).  Take a rinsed, room temperature or refrigerated, cabbage leaf and cut out the heavy vein out of the middle of the leaf.  The leaf or leaves are laid over the breast directly on the skin.  Putting on a bra or snug top over top of the leaves will keep them from falling off.  Remove the leaves when they are wilted and soft (usually within a few hours) or when the baby wants to feed again.  Fresh leaves can be applied after a feeding or when the first ones are wilted.

La Leche League Leaders can help you work through engorgement and other breastfeeding challenges.

http://www.lllc.ca/thursday-tip-cabbage-leaves-and-other-treatments-engorgement

More information about engorgement can be found by clicking here.

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

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