Benefits of Cabbage Leaves for Relief of Engorged Breasts

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In response to a photo showing a woman taping a cabbage leaf onto her knee to help with her osteoarthritis, doctors wrote in asserting that “Cabbage leaves can help inflammation of any body part….You may even find that there is a cache of cabbage in the fridge of your local maternity unit.” Why? Well, not only is cabbage cheaper than gel packs, but knees are not the only “anatomical shapes” that the leaves “conform well to.”

“Breast engorgement”—when the breasts become overfilled with milk during breastfeeding, becoming hard, tight, and painful—can negatively impact both mother and infant alike. So, why not put cabbage leaves on them? A lactation consultant in a breastfeeding journal suggests wearing cabbage leaves. Evidently works like a charm, and once the swelling goes down, “frequent breastfeeding” should help the breasts from refilling too much.

Where did she even get the idea for this? Well, her son got in a car accident, she “wrapped his leg in cabbage,” and the rest is history. The only adverse side effect identified was a complaint from the son, who felt “like a vegetable.”

“Based on the information [she] collected, [she concluded that] cool green cabbage compresses have anti-inflammatory, anti-edema [anti-swelling] and anti-infectious properties.” But, you don’t really know, until you…put it to the test. Yeah, but who’s going to do a randomized, controlled study of cabbage leaves? Scientists, that’s who. “Do cabbage leaves prevent breast engorgement?” Let’s find out.

120 women randomized to apply “cabbage leaves to their breasts,” or not. Though the cabbage group “tended to report less breast engorgement,…the trend was not statistically significant,” though one of the big things you care about is premature weaning. And, the cabbage group did seem able to extend the time they were exclusively breastfeeding. So, while they couldn’t “rule out the possibility that cabbage leaves had a direct effect on breast engorgement,…[the leaves] may have contributed to the increased breastfeeding success in the experimental group.” However, the researchers “consider…the positive effect [to be] more likely [due to] psychological mechanisms”—in other words, the placebo effect. They did weed out some of the true believers, though, as some women refused to join the study out of fear they might end up in the control group, and not be able to use them.

A similar study performed recently found that while adding cabbage leaves to early breast care didn’t significantly reduce pain, it did seem to significantly reduce breast hardness. Since it probably can’t hurt, some women might want to just give it a try. But, it would be nice to get some more concrete answers. Like, how about a treatment trial instead of just prevention? You could try hot cabbage leaves versus cold cabbage leaves. To control for the placebo effect, you could use placebo cabbage, like iceberg lettuce leaves or something. In fact, since both breasts are affected, women could act as their own controls, with cabbage on one breast and turning over a new leaf on the other.

How about a comparison of “Chilled Cabbage Leaves [versus] Chilled Gelpacks”? Just cold alone “decreases blood flow” and might, therefore, “decrease engorgement.” On the other hand, maybe cabbage leaves contain some component “that the mother’s skin absorbs” that somehow helps. You don’t know, until you…put it to the test.

“Thirty-four lactating women with breast engorgement.” One breast got the cabbage; one breast got the gel pack. “Their pain levels were established [before and after]….” And: “There was no difference.’ They both appeared to work about just as well, with two-thirds reporting relief within hours either way—though, interestingly, “[t]he majority of mothers preferred the cabbage leaves.”

“The similarity in the effect…may have been caused by the fact that both applied cold,” although you’d think “the effects of the cold in the cabbage leaves would have been transitory.” So, hey, maybe there’s something special in cabbage leaves, after all? What you’d have to do is like a comparison of “Chilled [versus] Room Temperature Cabbage.” Okay, here you go! One breast gets the “chilled cabbage” leaf, and the other gets a “room-temperature cabbage” leaf. And: “There was no difference” between the two. They both seemed to work, suggesting that it’s not the cold itself that’s doing it. But, we still don’t know what role the placebo effect is playing.

If you were going to design a study to determine if there was some special compound in cabbage that could decrease breast engorgement, what would you do? You could try the iceberg lettuce. But, if women have heard about the cabbage effect, they might have an expectation bias in favor of the cabbage. Aha! How about using a “cabbage leaf extract”? Then, you can finally do a “double-blind experiment” where women don’t know which breasts are exposed to the cabbage by asking them to rub on a cream containing a cabbage-leaf extract versus a “placebo cream.” They added some rosewater to both creams to try to “camouflage any residual [cabbage] odor,” and “no difference” in relief. Now, “the decrease in discomfort produced by the cream…was not as strong as that produced by the real cabbage leaves…in [the] previous studies.”

The superiority of the whole leaves “might be explained by a failure of the extract to contain the potentially active chemical,” or maybe the chemical broke down, or maybe it wasn’t concentrated enough, or maybe there was just a powerful placebo effect of wearing cabbage leaves. The bottom line is that, “[e]ven though no active pharmacological substance in cabbage leaves has been identified…,its convenient shape [of cabbage leaves, their] low cost, wide availability, and purported soothing effect make it a sought after treatment.”

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• Munns A. Cabbage leaves can help inflammation of any body part. BMJ. 2003;327:451.
• Corrieri D. Cabbage leaves: an effective treatment for swollen tissues. J Hum Lact. 1992;8(3):126-127.
• Nikodem VC, Danziger D, Gebka N, Gulmezoglu AM, Hofmeyr GJ. Do cabbage leaves prevent breast engorgement? A randomized, controlled study. Birth. 1993;20(2):61-4.
• Roberts KL. A comparison of chilled cabbage leaves and chilled gelpaks in reducing breast engorgement. J Hum Lact. 1995;11(1):17-20.
• Roberts KL, Reiter M, Schuster D. A comparison of chilled and room temperature cabbage leaves in treating breast engorgement. J Hum Lact. 1995;11(3):191-4.
• Lim AR, Song JA, Hur MH, Lee MK, Lee MS. Cabbage compression early breast care on breast engorgement in primiparous women after cesarean birth: a controlled clinical trial. Int J Clin Exp Med. 2015;8(11):21335-42.
• Roberts KL, Reiter M, Schuster D. Effects of cabbage leaf extract on breast engorgement. J Hum Lact. 1998;14(3):231-6.
• Mangesi L, Zakarija-grkovic I. Treatments for breast engorgement during lactation. Cochrane Database Syst Rev. 2016;(6):CD006946.

Image credit: Macro Verch via Flickr. Image has been modified.

Motion graphics by Avocado Video.

• arthritis
• breast health
• breast milk
• breast pain
• breastfeeding
• cabbage
• cruciferous vegetables
• infants
• inflammation
• osteoarthritis
• placebo effect