Cabbage

Drug Levels and Effects:




Summary of Use during Lactation:


Cabbage (Brassica oleracea)leaveshave been applied topically to the breasts to treat breast engorgement.[1][2][3][4] Some investigators cut out a hole in theleavesto keep the nipples dry.Leaveshave been applied frozen, refrigerated or at room temperature. Various studies found cabbageleavesbeneficial for reducing breast engorgement and pain regardless of temperature. However, a meta-analysis concluded that there is no good evidence that topical cabbageleaveswere better than no treatment, because engorgement tends to improve over time regardless of treatment. The authors felt that the intervention was cheap, unlikely to cause harm and might be soothing for the mother.[5] Unrestricted nursing of the infant may be an important factor in reducing engorgement.[1][4] Some low-quality evidence indicates that maternal cabbage ingestion might cause colic in their breastfed infants.[6]


Drug Levels:


Maternal Levels.

Relevant published information was not found as of the revision date.

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


No side effects have been reported after topical application of cabbageleavesto the breast. Maternal cabbage intake was studied as a possible cause of colic in breastfed infants. A questionnaire was sent to nursing mothers asking about food intake during the previous week and their infants' symptoms of colic during that time. Seventy-three mothers who reported colic in their infants during the prior week were 30% more likely to have eaten cabbage during this time than mothers of infants who did not have colic during the previous week. Additionally, many other mothers reported avoiding cruciferous vegetables (e.g., broccoli, cabbage, cauliflower) because of previous symptoms of colic in their breastfed infants that they attributed to these foods.[6]


Possible Effects on Lactation:


In a randomized, nonblinded study, postpartum hospitalized women with breast engorgement during breastfeeding either applied refrigerated cabbageleavesto their breasts (n = 59) or received routine hospital care (n = 56). The women who used the cabbageleavesbreastfed exclusively for slightly longer than those who did not (36 vs 30 days). At 6 weeks postpartum, there was no statistical difference in the percentage of women breastfeeding between the two groups The authors felt that any difference was most likely caused by psychological mechanisms in the mothers than the cabbageleaves.[1] This study suffered from a 20% loss to follow-up.

A study investigated cabbageleavesat different temperatures in the treatment of breast engorgement in hospitalized postpartum women (n = 28). Each mother received chilledleavesto one breast and room temperatureleavesto the other in a randomized order. Both treatments reduced perceived breast pain, but no difference was found between the chilled and room temperature cabbageleavesin reducing the pain of engorgement.[2]

A study compared chilled cabbageleavesto cold gelpacks in the treatment of breast engorgement in hospitalized postpartum women (n = 33). Both had cutout areas around the nipple. Affected women applied a cabbageleafto one breast and the gelpack to the other as needed at 2- to 4-hour intervals. There was no difference in the breast pain reduction between the cabbageleavesand gelpacks.[3]

A randomized, double-blind study compared a cream containing cabbage extract (n = 21) to a placebo cream (n = 18) for treating breast engorgement. The cream was specially made for the study using a 1% cabbage extract according to the methods of the British Pharmacopoeia and the same cream base as the placebo. Mothers rated their pain and breast firmness, and a device was used by researchers to measure breast firmness. Both treatments improved all measured parameters, with no difference between the two treatments. Nursing the infant had a greater effect on perceptions of discomfort and the hardness of the breast tissue than either of the creams.[4]

A study compared the effectiveness of topical use of alternating cold and hot compresses (n = 30) to frozen cabbageleaves(n = 30) for the treatment of breast engorgement. The study was not randomized or blinded. Each treatment was applied for 30 minutes 3 times daily for 2 days. Outcomes were judged using breast engorgement and pain scales, although it is unclear who did the rating. Both treatments were effective in reducing pain and engorgement. The authors concluded that hot and cold compresses were more effective than cabbageleaves,[7] but this conclusion is not justified by the study design.


References:


1. Nikodem VC, Danziger D, Gebka N et al . Do cabbageleavesprevent breast engorgement? A randomized, controlled study. Birth. 1993 ;20:61-4. PMID:8240608
2. Roberts KL, Reiter M, Schuster D. A comparison of chilled and room temperature cabbageleavesin treating breast engorgement. J Hum Lact. 1995;11:191-4. PMID:7669238
3. Roberts KL. A comparison of chilled cabbageleavesand chilled gelpaks in reducing breast engorgement. J Hum Lact. 1995;11:17-20. PMID:7718101
4. Roberts KL, Reiter M, Schuster D. Effects of cabbageleafextract on breast engorgement. J Hum Lact. 1998;14:231-6. PMID:10205435
5. Mangesi L, Dowswell T. Treatments for breast engorgement during lactation. Cochrane Database Syst Rev. 2010;9:CD006946. PMID:20824853
6. Lust KD, Brown JE, Thomas W. Maternal intake of cruciferous vegetables and other foods and colic symptoms in exclusively breast-fed infants. J Am Diet Assoc. 1996;96:46-8. PMID:8537569
7. Arora S, Vatsa M, Dadhwal V. Cabbageleavesvs hot and cold compresses in the treatment of breast engorgement. Nurs J India. 2009;100:52-4. PMID:19588654



Substance Identification:




Substance Name:

Cabbage

Scientific Name:

Brassica oleracea

Drug Class:


  • Complementary Therapies

  • Food

  • Phytotherapy

  • Plants, Medicinal


  • Administrative Information:




    LactMed Record Number:


    866


    Last Revision Date:


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