Treatments for breast engorgement during lactation

Area of Science:

• Obstetrics and Gynecology
• Lactation Support
• Evidence-Based Medicine

Background:

• Breast engorgement, a common postpartum issue, causes pain and can lead to breastfeeding cessation.
• Effective interventions for engorgement are not well-established, impacting maternal and infant health.
• This review synthesizes evidence on various treatments for breast engorgement.

Purpose of the Study:

• To evaluate the effectiveness and safety of diverse treatments for breast engorgement in breastfeeding women.
• To provide an updated overview of randomized controlled trials on engorgement interventions.

Main Methods:

• Searched multiple databases including Cochrane, ClinicalTrials.gov, and ICTRP for relevant randomized controlled trials.
• Included 21 studies involving 2170 women, examining interventions like cabbage leaves, compresses, massage, and medical treatments.
• Assessed trial eligibility, extracted data, and evaluated the certainty of evidence using GRADE methodology.

Main Results:

• Cold cabbage leaves may reduce breast pain and hardness compared to routine care, with low to very low certainty evidence.
• Herbal compresses and massage therapy showed potential benefits for pain and hardness, though evidence quality was low.
• Medical treatments like protease and serrapeptase demonstrated possible reductions in pain, swelling, and engorgement, with low certainty.

Conclusions:

• While interventions like cabbage leaves, cold gel packs, compresses, and massage show potential, the low certainty of evidence limits definitive conclusions.
• Further high-quality research with larger sample sizes and appropriate units of analysis is necessary to establish robust findings.
• Current evidence suggests promising but uncertain benefits for various breast engorgement treatments.