The following describes the used 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. Some will say to use the cabbage
leaves after each feeding and leave them on until they wilt. I have
not enough experience with cabbage leaves to say one way or the other,
but some are concerned that such frequent use will decrease the milk
supply.
- 4. Stop using as soon as engorgement is beginning to diminish and you
are becoming more comfortable.
- 5. You can use acetaminophen (Tylenol, others) with or without
codeine, ibuprofen, or other medication 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.
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, Purlan 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:
- 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.
- 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.
- An antiinflammatory agent. Often it is the inflammation
associated with infection or injury that causes the most pain.
The antiinflammatory agent (a steroid) decreases the
inflammatory response.
In Canada, Kenacomb (more easily available) or
Viaderm KC (less expensive) ointments contain the above
ingredients. Ointments can also be made up from individual
ingredients. In the USA, mixing 2% mupirocin ointment + nystatin
ointment + betamethasone 0.1% ointment results in a similar, even
better, concoction. It can also be prescribed in Canada.
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.
This article may be copied and
distributed
without further permission
 About the
Author
JACK NEWMAN
graduated from the University of Toronto medical school as a pediatrician in 1970. He
started the first hospital-based breastfeeding clinic in Canada in 1984 at Toronto's
Hospital for Sick Children. He has been a consultant with UNICEF for the Baby Friendly
Hospital Initiative in Africa, and has published articles on the subject of breastfeeding
in Scientific American and several medical journals. Dr. Newman has practiced as a
physician in Canada, New Zealand, and South Africa.
If you would like to contact Dr. Newman, you can mail him at: newman@globalserve.net
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