A comparison of chilled cabbage leaves and chilled gelpaks in reducing breast engorgement. The clinical effects of "protease complex" on postpartum breast engorgement (based on the double blind method). A comparison of chilled and room temperature cabbage leaves in treating breast engorgement. A randomised-controlled trial in Sweden of acupuncture and care interventions for the relief of inflammatory symptoms of the breast during lactation. Effects of acupuncture and care interventions on the outcome of inflammatory symptoms of the breast in lactating women.
This study compared the effectiveness of chilled green cabbage leaves and chilled gelpaks in reducing breast engorgement in postpartum mothers. Thirty-four lactating women with breast engorgement used chilled cabbage leaves on one breast and chilled gelpaks on the other for up to eight hours. Their pain levels were established pre-treatment and compared post-treatment for both conditions. There was no difference in the post-treatment ratings for the two treatments. Mothers reported a statistically significant drop in pain with both treatments; 68 percent obtained relief within one to two hours. The majority of mothers preferred the cabbage leaves. nan This study compared the effectiveness of chilled and room temperature green cabbage leaves in reducing the discomfort of breast engorgement in postpartum mothers. Twenty-eight lactating women with breast engorgement used chilled cabbage leaves on one breast and room-temperature cabbage leaves on the other for a two-hour period. Pre-treatment pain levels were compared with post-treatment levels for both conditions. There was no difference in the post-treatment ratings for the two treatments; mothers reported significantly less pain with both treatments. We concluded that it is not necessary to chill cabbage leaves before use. to further compare acupuncture treatment and care interventions for the relief of inflammatory symptoms of the breast during lactation and to investigate the relationship between bacteria in the breast milk and clinical signs and symptoms.
                randomised, non-blinded, controlled trial of acupuncture and care interventions.
                a midwife-led breast feeding clinic in Sweden.
                205 mothers with 210 cases of inflammatory symptoms of the breast during lactation agreed to participate. The mothers were randomly assigned to one of three treatment groups, two of which included acupuncture among the care interventions and one without acupuncture. All groups were given essential care. Protocols, which included scales for erythema, breast tension and pain, were maintained for each day of contact with the breast feeding clinic. A Severity Index (SI) for each mother and each day was created by adding together the scores on the erythema, breast tension and pain scales. The range of the SI was 0 (least severe) to 19 (most severe).
                no significant difference was found in numbers of mothers in the treatment groups, with the lowest possible score for severity of symptoms on contact days 3, 4 or 5. No statistically significant differences were found between the treatment groups for number of contact days needed until the mother felt well enough to discontinue contact with the breast feeding clinic or for number of mothers prescribed antibiotics. Significant differences were found in the mean SI scores on contact days 3 and 4 between the non-acupuncture group and the two acupuncture groups. Mothers with less favourable outcomes (6 contact days, n=61) were, at first contact with the midwife, more often given advice on correction of the baby's attachment to the breast. An obstetrician was called to examine 20% of the mothers, and antibiotic treatment was prescribed for 15% of the study population. The presence of Group B streptococci in the breast milk was related to less favourable outcomes.
                if acupuncture treatment is acceptable to the mother, this, together with care interventions such as correction of breast feeding position and babies' attachment to the breast, might be a more expedient and less invasive choice of treatment than the use of oxytocin nasal spray. Midwives, nurses or medical practitioners with specialist competence in breast feeding should be the primary care providers for mothers with inflammatory symptoms of the breast during lactation. The use of antibiotics for inflammatory symptoms of the breast should be closely monitored in order to help the global community reduce resistance development among bacterial pathogens. To compare modes of care and treatment for lactating women with inflammatory symptoms of the breast, with special focus on the use of acupuncture.
                Eighty-eight mothers were randomized into three treatment groups. All three groups were given advice regarding emptying of the breasts and care in the form of comfort interventions. Acupuncture was included in the treatment regime for two of the groups. A severity index was created by adding together scores for signs and symptoms: breast tension, erythema and pain.
                Mothers in all groups expressed relative satisfaction with the breastfeeding situation despite considerable discomfort. There was no significant difference between the groups for the number of mothers requiring more than three contact days for recovery nor for their severity index scores on day 3. These findings must be interpreted with care but may suggest that care interventions play as great a part in the recovery of these women as acupuncture treatment or the use of oxytocin spray. Antibiotic therapy was used in 9% of the study population, which is in contrast to other studies. PROPOSED FUTURE ACTION: Based on these results, a new study has been designed to test the hypothesis that acupuncture hastens recovery from inflammatory processes in the lactating breast and approximately 200 mothers will be randomized in a new expanded study.
Allthough some interventions may be promising, there is not sufficient evidence from trials on any intervention to justify widespread implementation. More research is needed on treatments for this painful and distressing condition.