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Your Care InstructionsBreast engorgement is the painful overfilling of the breasts that can occur during breastfeeding. It usually occurs when your breasts make more milk than your baby can drink, when you are unable to breastfeed or pump, and when you stop breastfeeding your baby. Breast engorgement can make it hard for your baby to latch on to your nipple. Your baby may then be unable to breastfeed. This makes engorgement worse. If you breastfeed or pump, engorgement should get better in a few days. If you've stopped breastfeeding, it can take longer. Over time, your body will stop making milk. This can take up to several weeks. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take. How can you care for yourself at home?
To prevent breast engorgement
When should you call for help?Call your doctor now or seek immediate medical care if:
Watch closely for changes in your health, and be sure to contact your doctor, midwife, or nurse call line if:
Where can you learn more?Go to https://www.healthwise.net/patientEd Enter Z048 in the search box to learn more about "Breast Engorgement: Care Instructions". Indian J Community Med. 2008 Jul; 33(3): 160–162. To assess and compare the efficacy of cold cabbage leaves and hot and cold compresses in the treatment of breast engorgement. This was a
quasi-experimental study conducted in the postnatal ward of the All India Institute of Medical Sciences (AIIMS), New Delhi. The study comprised a total of 60 mothers;30 in the experimental group and 30 in the control group. The control group received alternate hot and cold compresses and the experimental group received cold cabbage leaf treatment for relieving breast engorgement. The pre- and posttreatment scores of breast engorgement and pain were recorded. The data were analyzed using
descriptive and inferential statistical methods using the statistical software STRATA. Both the treatments, i.e., hot and cold compress and cabbage leaves were effective in decreasing breast engorgement and pain in postnatal mothers (P ≤ 0.001).Cold cabbage leaves and hot and cold compress were both equally effective in decreasing breast engorgement (P = 0.07), whereas hot and cold compresses were found to be
more effective than cold cabbage leaves in relieving pain due to breast engorgement (P ≤ 0.001) in postnatal mothers. Cold cabbage leaves as well as alternate hot and cold compresses both can be used in the treatment of breast engorgement. Hot and cold compresses are more effective in decreasing pain than cold cabbage leaves in relieving pan due to breast engorgement. Keywords:
Breast engorgement, hot and cold compress, treatment Breast engorgement is a physiological condition that is characterized by painful swelling of the breasts as a result of a sudden increase in milk volume, lymphatic and vascular congestion, and interstitial edema during the first two weeks following childbirth; this condition is caused by insufficient breastfeeding and/or obstruction in milk ducts.
Breast pain during breastfeeding is a common problem that interferes with successful breastfeeding leading to exclusive abandonment of breastfeeding.(1) Over the years, numerous strategies for the treatment of this problem have been employed such as kangaroo care, fluid limitation, binding the breasts or wearing a tight brassiere, hot and cold compresses, and application of cabbage leaves. Very
few researches have been conducted tomonitor the effect of cabbage leaves on breast engorgement with inconclusive and conflicting results. A study on the efficacy of cabbage leaves can contribute to provide evidence for introducing this intervention in clinical practice; thus, we conducted the present study. We carried out a quasi-experimental study, using a time series, nonequivalent control group design, with
multiple institutions of treatment in the postnatal ward at All India Institute of Medical Sciences (AIIMS), New Delhi; we conducted the study in 60 subjects between May 2006 and December 2006. Postnatal mothers with breast engorgement Willingness to participate in the study Exclusion criteria
The subjects were enrolled based on the inclusion and exclusion criteria, and informed consent was then obtained from them. The identification data and obstetric characteristics of each subject were recorded in a validated subject data sheet. The study was conducted in two phases. In the first phase, first 30 mothers in the control group were administered alternate hot and cold compresses. Alternate warm moist sponge cloths and cold compresses were applied to the engorged breasts; the cloths were replaced frequently after 1–2 min. This process was continued for 20 min. The temperature of water for hot compress ranged between 43°C and 46°C, and that for cold compress ranged between 10°C and 18°C as assessed by alotion thermometer. After the completion of the first phase, the next 30 mothers in the experimental group were administered cold cabbage leaf treatment for relieving breast engorgement. Cabbage leaves were refrigerated in the freezer for approximately 20–30 min prior to the procedure. Cold cabbage leaves were placed inside the women's brassiere for 30 min. Both the treatments were performed three times a day for two continuous days. This method was applied six times on each subject. The duration of each intervention was 30 min. The pre- and posttreatment scores of breast engorgement and pain were recorded after each treatment session. Breast engorgement was measured using a six-point breast engorgement scale,(2) and the pain score was assessed using a numerical rating pain scale. The data obtained was processed in MS Excel sheet. The statistical analysis was performed using the software STRATA. ResultsThe two groups were homogeneous with regard to alldemographic and obstetric variables as analyzed by chi-square and Fisher's exact test except for breastfeeding for which adjusted analysis using generalized estimating equations (GEE) was performed. By using the student,s t test, no difference was noted between the groups with regard to the pretreatment scores of breast engorgement and pain. GEE was used to compare the correlated responses for the posttreatment scores for both the outcome variables between the two groups and to compare the pre- and posttreatment scores within the groups. Both the treatments, i.e., hot and cold compress and cabbage leaves, were effective in decreasing breast engorgement and pain in postnatal mothers (P ≤ 0.001) as shown in Table 1. Both the cold cabbage leaves and hot and cold compress procedures were equally effective in decreasing breast engorgement (P = 0.07) as shown in Table 2. Hot and cold compresses were found to be more effective than cold cabbage leaves in relieving pain due to breast engorgement (P ≤ 0.001) in postnatal mothers. Table 1Comparison of the pre- and posttreatment scores for breast engorgement and pain in both groups
Table 2Comparison of the posttreatment breast engorgement scores in postnatal mothers in both groups
DiscussionThis study was supported by the findings of Snowden HM et al.(3) who reviewed research studies to determine the effects of several interventions to relieve symptoms of breast engorgement among breastfeeding women and found that cabbage leaves were effective in the treatment of this painful condition. Cabbage leaves were preferred by the mothers. The advantage of using cabbage leaves is its low cost and convenience as compared to other medical regimens. Roberts KL et al.(4) also compared the efficacy of cabbage leaf extract with that of a placebo in the treatment of breast engorgement in lactating women; they concluded that both the groups received equal relief from the discomfort and the hardness in breast tissue decreased substantially. The present study also supports the findings of Hill PD and Humenick SS(2) who reported that the type of delivery and parity are not a critical variable in predicting breast engorgement. ConclusionCold cabbage leaves as well as alternate hot and cold compresses both can be used in the treatment of breast engorgement. Hot and cold compresses are more effective than cold cabbage leaves in relieving pain due to breast engorgement. AcknowledgmentsI thank my guide Dr. Manju Vatsa and co-guide Dr. Vatsla Dadhwal for their guidance throughout the study. I am grateful to the mothers who participated in this study and nurses of the postnatal ward who helped me during the course of study. I thank the statistical department for performing the statistical analyses for this study and the ethical review board for providing ethical clearance. FootnotesSource of Support: Nil Conflict of Interest: None declared. References1. Woolridge M. Aetiology of sore nipples. Midwifery. 1986;2:172–6. [PubMed] [Google Scholar] 2. Hill PD, Humenick SS. The occurrence of breast engorgement. J Hum Lactation. 1994;10:79–86. [PubMed] [Google Scholar] 3. Snowden HM, Renfrew MJ, Woolridge MW. Treatments for breast engorgement during lactation. Cochrane Database Syst Rev. 2001;2:CD000046. [PubMed] [Google Scholar] 4. Roberts KL, Reiter M, Schuster D. Effects of cabbage leaf extract on breast engorgement. J Hum Lactation. 1998;14:231–6. [PubMed] [Google Scholar] Articles from Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine are provided here courtesy of Wolters Kluwer -- Medknow Publications How do you get rid of engorged breasts fast?How can I treat it?. using a warm compress, or taking a warm shower to encourage milk let down.. feeding more regularly, or at least every one to three hours.. nursing for as long as the baby is hungry.. massaging your breasts while nursing.. applying a cold compress or ice pack to relieve pain and swelling.. Should I ice engorged breasts?This can make breast engorgement worse. Gently massage your breasts to help milk flow during breastfeeding or pumping. Apply a frozen wet towel, cold gel or ice packs, or bags of frozen vegetables to your breasts for 15 minutes at a time every hour as needed. (Put a thin cloth between the ice pack and your skin.)
Is a heating pad good for engorged breasts?To prevent breast engorgement
Put a warm, wet face cloth on your breasts before breastfeeding. This may help your breasts "let down," increasing the flow of milk. Or you can take a warm shower or use a heating pad set on low. (Never use a heating pad in bed, because you may fall asleep and burn yourself.)
How should I sleep with engorged breasts?Reclining. During early days of breastfeeding, engorgement can make your breasts feel sensitive and tender. Sleeping with elevated pillows on a slight recline can assist with this discomfort.
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