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Treatments for breast engorgement during lactation.

Abstract

BACKGROUND

Breast engorgement is a painful and unpleasant condition affecting large numbers of women in the early postpartum period. During a time when mothers are coping with the demands of a new baby it may be particularly distressing. Breast engorgement may inhibit the development of successful breastfeeding, lead to early breastfeeding cessation, and is associated with more serious illness, including breast infection.

OBJECTIVES

To identify the best forms of treatment for women who experience breast engorgement.

SEARCH STRATEGY

We identified studies for inclusion through the Cochrane Pregnancy and Childbirth Group's Trials Register (February 2010).

SELECTION CRITERIA

Randomised and quasi-randomised controlled trials where treatments for breast engorgement were evaluated.

DATA COLLECTION AND ANALYSIS

Two review authors assessed eligibility for inclusion and carried out data extraction.

MAIN RESULTS

We included eight studies with 744 women. Trials examined a range of different treatments for breast engorgement: acupuncture (two studies), cabbage leaves (two studies), cold gel packs (one study), pharmacological treatments (two studies) and ultrasound (one study). For several interventions (ultrasound, cabbage leaves, and oxytocin) there was no statistically significant evidence that interventions were associated with a more rapid resolution of symptoms; in these studies women tended to have improvements in pain and other symptoms over time whether or not they received active treatment. There was evidence from one study that, compared with women receiving routine care, women receiving acupuncture had greater improvements in symptoms in the days following treatment, although there was no evidence of a difference between groups by six days, and the study did not have sufficient power to detect meaningful differences for other outcomes (such as breast abscess). A study examining protease complex reported findings favouring intervention groups although it is more than 40 years since the study was carried out, and we are not aware that this preparation is used in current practice. A study looking at cold packs suggested that the application of cold does not cause harm, and may be associated with improvements in symptoms, although differences between control and intervention groups at baseline mean that results are difficult to interpret.

AUTHORS' CONCLUSIONS

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.

Authors+Show Affiliations

Epidemiological Research and Surveillance Management Directorate, Eastern Cape Department of Health, Private Bag X0038, Bisho, South Africa, 5605.No affiliation info available

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

20824853

Citation

Mangesi, Lindeka, and Therese Dowswell. "Treatments for Breast Engorgement During Lactation." The Cochrane Database of Systematic Reviews, 2010, p. CD006946.
Mangesi L, Dowswell T. Treatments for breast engorgement during lactation. Cochrane Database Syst Rev. 2010.
Mangesi, L., & Dowswell, T. (2010). Treatments for breast engorgement during lactation. The Cochrane Database of Systematic Reviews, (9), CD006946. https://doi.org/10.1002/14651858.CD006946.pub2
Mangesi L, Dowswell T. Treatments for Breast Engorgement During Lactation. Cochrane Database Syst Rev. 2010 Sep 8;(9)CD006946. PubMed PMID: 20824853.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatments for breast engorgement during lactation. AU - Mangesi,Lindeka, AU - Dowswell,Therese, Y1 - 2010/09/08/ PY - 2010/9/9/entrez PY - 2010/9/9/pubmed PY - 2010/10/19/medline SP - CD006946 EP - CD006946 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 9 N2 - BACKGROUND: Breast engorgement is a painful and unpleasant condition affecting large numbers of women in the early postpartum period. During a time when mothers are coping with the demands of a new baby it may be particularly distressing. Breast engorgement may inhibit the development of successful breastfeeding, lead to early breastfeeding cessation, and is associated with more serious illness, including breast infection. OBJECTIVES: To identify the best forms of treatment for women who experience breast engorgement. SEARCH STRATEGY: We identified studies for inclusion through the Cochrane Pregnancy and Childbirth Group's Trials Register (February 2010). SELECTION CRITERIA: Randomised and quasi-randomised controlled trials where treatments for breast engorgement were evaluated. DATA COLLECTION AND ANALYSIS: Two review authors assessed eligibility for inclusion and carried out data extraction. MAIN RESULTS: We included eight studies with 744 women. Trials examined a range of different treatments for breast engorgement: acupuncture (two studies), cabbage leaves (two studies), cold gel packs (one study), pharmacological treatments (two studies) and ultrasound (one study). For several interventions (ultrasound, cabbage leaves, and oxytocin) there was no statistically significant evidence that interventions were associated with a more rapid resolution of symptoms; in these studies women tended to have improvements in pain and other symptoms over time whether or not they received active treatment. There was evidence from one study that, compared with women receiving routine care, women receiving acupuncture had greater improvements in symptoms in the days following treatment, although there was no evidence of a difference between groups by six days, and the study did not have sufficient power to detect meaningful differences for other outcomes (such as breast abscess). A study examining protease complex reported findings favouring intervention groups although it is more than 40 years since the study was carried out, and we are not aware that this preparation is used in current practice. A study looking at cold packs suggested that the application of cold does not cause harm, and may be associated with improvements in symptoms, although differences between control and intervention groups at baseline mean that results are difficult to interpret. AUTHORS' CONCLUSIONS: 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. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/20824853/Treatments_for_breast_engorgement_during_lactation_ L2 - https://doi.org/10.1002/14651858.CD006946.pub2 DB - PRIME DP - Unbound Medicine ER -