Lactation consultants frequently suggest compresses made from green cabbage leaves to reduce swelling in moderate to severe engorgement. References to cabbage compresses for swelling and engorgement date back to the early 1800's. Cabbage compresses were used to reduce the swelling in sprains and broken bones.

Research data is sparse but published studies and anecdotal reports seem to support the value of cabbage compresses in reducing breast engorgement.

The common green cabbage (Brassica capitata) is used for engorgement therapy. Cabbage is known to contain sinigrin (allylisothiocyanate) rapine, mustard oil, magnesium, oxylate and sulphur heterosides. Herbalists believe that cabbage has both antibiotic and anti irritant properties. (Lawrence and Lawrence 257-258)

It is theorized that this natural mixture of ingredients from "Mother Nature's Kitchen" helps decrease tissue congestion by dilating (opening) local capillaries (small blood vessels) which improves the blood flow in and out of the area and allowing the body to reabsorb the trapped fluid in the breasts. In many cases, science is finding that recipes for cures from "Mother Nature's Kitchen" can't be duplicated in the laboratory. I believe that this is the reason why a gel made from cabbage leaf extract was not effective in treating engorgement (Roberts, Reiter and Schuster 1998). The use of cabbage leaves alone are not effective unless combined with other measures such as getting the baby to the breast and/or pumping.

Medical providers and lactation consultants often see trapped fluid throughout the mother's body after a baby is born in her face, hands, lower legs, and feet (especially if mother is diabetic, has lots of I.V. fluids and/or an epidural in labor). Lactation consultants are reporting a peculiar type of swelling in the breasts of some women who have an epidural during labor that makes the areola so swollen that it cannot be compressed for adequate latch on by the baby. The only logical conclusion that can be drawn from this anecdotal evidence is: if the rest of the body visibly swells with extra fluid, so do the breasts. However, we have no current research to validate this conclusion. No adverse effects from using cabbage compresses have been reported.**

Cabbage compresses should always be used with other engorgement treatment routines. CABBAGE IS NOT RECOMMENDED FOR INDIVIDUALS WHO ARE ALLERGIC TO SULFA (please see note * below) OR CABBAGE.

In addition, cabbage compresses should not be used if the skin is broken (i.e., cracked, bleeding or blistered nipples etc....) If the skin is broken, place the cabbage leaves around the breast without covering irritated skin.

* No one really knows were this caution regarding sulfa originated or if it is true. Cabbage does contain sulfur compounds which are not the same as sulfa. I have seen 2 moms, allergic to sulfa, react to the cabbage compresses with hives, so I am reluctant to discontinue the caution.

However, if you are allergic to sulfa do a patch test : take a small amount of crushed fresh cabbage and put it on the delicate skin of your forearm, wrap something around it to keep it in place. If there is no reaction in 1 to 2 hours, I think you can assume that you will not react to the cabbage.

**Please, if you do experience any negative reaction to the cabbage compresses, email me with the details. We need to get any reactions documented for future reference.

Instructions for use:

• Remove the core and gently peel individual leaves away from the center of the head pulling outward. Try to avoid tearing the leaves, but it's OK if they shred a little.

• Thoroughly wash the leaves.

• Leaves can be chilled in the refrigerator for extra benefits. Cool compresses tend to relieve swelling more effectively warm compresses. Some mom's find that crushed ice over the cabbage leaves also helps. Note: Some cultures strongly believe that placing anything cold or cool on the breast ruins the milk (and some believe that cold exposure of the chest ruins the milk forever). These are merely cultural beliefs and have no basis in scientific fact yet need to be respected.

• Just before use, crush the veins with a rolling pin or similar object or slice off the tops of the "veins" with a sharp knife.

• Drape several leaves over each breast. Use enough to cover ALL the engorged tissue, even swollen tissue under your arms.

• Leave on until they become wilted, about 20 to 30 minutes. See Joan Fisher's tips below.

• Repeat application of cabbage leaves three or four times (about every 4 to 6 hours) per 24 hours until engorgement subsides (usually 1 or 2 days). If the engorgement is severe, compresses can be used as often as needed.

• For the mother who is not breastfeeding, cabbage compresses can be used to help reduce the swelling in her breasts.

• Discontinue direct use immediately if skin breaks out, blisters or becomes irritated. (If this should happen ** please email me the details.)

• Place the leaves so they do not touch any already irritated areas.

I have used cabbage compresses for my family and friends. From sprained ankles, wrists and even after my daughter had 4 impacted wisdom teeth surgically removed. When we ran out on the second day, she begged me to go out and get more cabbage. According to her the cabbage helped so much with the pain that she didn't need the pain pills the doctor prescribed. She also said just using an ice pack made it hurt worse. When I told the dentist, he laughed at first, until he saw how little swelling and bruising she had 3 days after the surgery. He's a cabbage convert :-) The dentist now recommends cabbage leaves to all his patients. He tells me everyone raves about how good the cabbage feels and how little swelling and bruising he sees after the procedure when the patient uses the cabbage compresses.

We just used it "in the family" for persistent swelling following knee surgery. It worked as well, if not better, than the circulating ice water pad the doctor prescribed. I was sorry I hadn't thought of it sooner.

Here's some really great tips about using cabbage leaves from Joan Fisher that differ slightly from my own:
 

1. Put fresh cabbage leaves on after each feeding and leave them on until the next feed.

2. Discontinue use when the leaves are no longer coming off the breast limp with beads of water on them. [Joan says, "The moms say the cabbage leaves tell them when they don't need them anymore."]

3. Don't worry that the cabbage leaves will reduce your milk supply - they act on the fluid in the interstitial spaces (or the spaces between the cells where the swelling actually is) and does not affect the milk in the ducts. As long as mom continues regular milk removal by feeding or pumping she will continue to make milk.

Currently, I believe because more people then ever before are using cabbage leaves for treatment of engorgement, lactation consultants are gaining further clinical experience using them. Initial isolated reports of cabbage leaves completely drying up a mother's milk were wrong and perhaps a bit over cautious. We know that milk will continue to be made as long as milk is removed from the breast. That is why it is critical that cabbage leaf compresses be used along with other engorgement measures. I have found old references regarding the use of cabbage leaves for all types of swelling not related to the breast. I am convinced that the cabbage leaves themselves work only on the trapped fluid around the lactating tissue and not the milk volume in the ducts.