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Online Guide to Breastfeeding
"Treatments for Problems"
By Jack Newman, MD, FRCPC
The following describes the use of some treatments for breastfeeding mothers who are having various problems.
Cabbage leaves for engorgement:
Severe engorgement about the third or fourth day after the baby is born can usually be prevented by getting the
baby latched on well and drinking well from the very beginning. If you do become engorged, please understand
that engorgement diminishes within 1 or 2 days even without any treatment. Continue to breastfeed the baby,
making sure he gets on well and nurses well. However, if you should get engorged to the point of severe
discomfort, cabbage leaves seem to help decrease the engorgement more rapidly than ice packs or other
treatments. If you are unable to get the baby latched on, start cabbage leaves, start expressing your milk and give
the expressed milk to the baby by spoon, cup, finger feeding or eyedropper and get help quickly.
1. Use green cabbage.
2. Crush the cabbage leaves with a rolling pin if the leaves do not accommodate to the shape of your breast.
3. Wrap the cabbage leaves around the breast and leave on for about 20 minutes. Twice daily is enough. It is
usual to use the cabbage leaf treatment two or three times or less.
4. Stop using as soon as engorgement is beginning to diminish and you are becoming more comfortable.
5. You can use acetaminophen (TylenolTM, others) with or without codeine for pain relief. As with almost all
medications, there is no reason to stop breastfeeding when taking analgesics.
6. Ice packs also can be helpful.
7. If you are one of the women who gets a large lump in the armpit about 3 or 4 days after the baby's birth,
you can use cabbage leaves in that area as well.
Herbs for Increasing Milk Supply:
It is quite possible that herbal remedies help increase milk supply. There are several drugs which
obviously do increase milk supply, and of course it is reasonable to assume that some plants and
herbs might contain similar pharmacologic agents. Almost every culture has some sort of herb or plant
or potion to increase milk supply. Some may work as placebos, which is fine, some may have an
active ingredient. Some will have active ingredients which will not increase the milk supply but have
other effects. Note that even herbs can have side effects, even serious ones. Natural source drugs are
still drugs, and there is no such thing as a 100% safe drug. Luckily, as with most drugs, the baby will
get only a tiny percentage of the mother's dose. The baby is thus extremely unlikely to have any side
effects at all from the herbs. Two herbal treatments that seem to increase the milk supply are
fenugreek and blessed thistle, in the following dosages:
- fenugreek: 3 capsules 3 times a day
- blessed thistle: 3 capsules 3 times a day, or 20 drops of the tincture 3 times a day
The tincture container states that blessed thistle should not be taken by nursing mothers, presumably
because of the tiny amount of alcohol the mother would get. Don't worry about this. Teas also work,
but to take enough to make a difference, you will be drinking tea all day and night.
Other herbal treatments which have been used to increase milk supply are: raspberry leaf, fennel,
brewer's yeast. The effectiveness of none of these treatments has been proved.
All purpose nipple ointment:
The best treatment of nipple soreness is prevention. The best prevention is an early start to
breastfeeding and a good latch. More than minimal nipple pain in the first two or three days after your
baby's birth is due to a poor latch, no matter who tells you the latch is fine. Get help.
Sometimes nipple ointments such as LansinohTM, PurlanTM and others can be very useful for mild to
moderate pain, but fixing the latch is still the best treatment. Sometimes a "good-for-all-things-don't-know-why-it-works" nipple ointment can also be very useful.
You may be prescribed such an ointment (which works better than a cream). It will contain:
1.One or more antibiotics. Almost all cracks and erosions have bacteria growing in the base.
Whether they are actually causing infection, or whether they merely delay healing is not known.
But it has been known for many years that antibiotic ointments help some mothers' nipple pain
get better.
2.An antifungal agent. Candida albicans can cause nipple soreness and cracking. Sometimes it is
not easy to tell what contribution this fungus causes to breastfeeding mothers' nipple soreness.
3.An antiinflammatory agent. Often it is the inflammation associated with infection or injury which
causes the most pain. The antiinflammatory agent (a steroid) decreases the inflammatory
response.
In Canada, KenacombTM (more easily available) or Viaderm KCTM (less expensive) ointments
contain the above ingredients. Ointments can also be made up from individual ingredients, our usual
practice now. In the USA, mixing MycologTM ointment with 2% mupirocin ointment results in a
similar concoction.
How to use? Apply the ointment sparingly after each feeding. Do not wash or wipe it off even if the
baby goes back to the breast within minutes. Most of the ingredients are not absorbed from the
baby's gut and will do him no harm. Once you are feeling better (usually within 2-5 days), you can
gradually decrease the use of the ointment until you are not using it at all. For some conditions, the
mother may have to use the ointment daily or twice daily to keep pain free. This is not a problem and
you may continue the use of the ointment for weeks or longer, if necessary.
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Reprinted with permission. The information contained on these pages is provided as a courtesy to My ParenTime's visitors. My ParenTime makes no representations or guarantees concerning the effectiveness of such information. In no event shall My ParenTime be held liable for any failure of such safety information. My ParenTime urges Parents to become more informed on Breastfeeding Information.
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