Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Sep 8:(9):CD006946.
doi: 10.1002/14651858.CD006946.pub2.

Treatments for breast engorgement during lactation

Lindeka Mangesi  1 , Therese Dowswell
Affiliations

Treatments for breast engorgement during lactation

Lindeka Mangesi et al. Cochrane Database Syst Rev. .

Update in

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.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

    1. Ingelman-Sundberg A. Early puerperal breast engorgement. Acta Paediatrica Scandinavica. 1953;32:399–402. - PubMed
    1. Kvist LJ, Wilde Larsson B, Hall-Lord ML, Rydhstroem H. Effects of acupuncture and care interventions on the outcome of inflammatory symptoms of the breast in lactating women. International Nursing Review. 2004;51(1):56–64. - PubMed
    1. Kvist LJ, Hall-Lord ML, Rydhstroem H, Larsson BW. A randomised-controlled trial in Sweden of acupuncture and care interventions for the relief of inflammatory symptoms of the breast during lactation. Midwifery. 2007;23:184–95. - PubMed
    1. McLachlan Z, Milne EJ, Lumley J, Walker BL. Ultrasound treatment for breast engorgement: a randomised double blind trial. Australian Journal of Physiotherapy. 1991;37(1):23–9. - PubMed
    2. McLachlan Z, Milne EJ, Lumley J, Walker BL. Ultrasound treatment for breast engorgement: a randomised double blind trial. Breastfeeding Review. 1993;2(7):316–20. - PubMed
    3. McLachlan Z, Milne J, Lumley J. The efficacy of ultrasound as a treatment for severe breast engorgement. Tenth International Congress World Confederation for Physical Therapy;; Sydney, Australia. 1987 May 17-22.1987. pp. 342–6.
    1. Murata T, Hanzawa M, Nomura Y. The clinical effects of “Protease complex” on postpartum breast engorgement (based on the double blind method) Journal of Japanese Obstetrical and Gynecological Society. 1965;12(3):139–47. - PubMed

References to studies excluded from this review

    1. Booker DE, Pahl IR, Forbes DA. Control of postpartum breast engorgement with oral contraceptives. II. American Journal of Obstetrics and Gynecology. 1970;108:240–2. - PubMed
    1. Filteau SM, Lietz G, Mulokozi G, Bilotta S, Henry CJ, Tomkins AM. Milk cytokines and subclinical breast inflammation in Tanzanian women: effects of dietary red palm oil or sunflower oil supplementation. Immunology. 1999;97:595–600. - PMC - PubMed
    1. Garry J. Estrogen-androgen preparation for prevention of postpartum breast engorgement and lactation. Obstetrics & Gynecology. 1956;7:422–4. - PubMed
    1. Kee WH, Tan SL, Lee V, Samon YM. The treatment of breast engorgement with serrapeptase (Danzen): a randomized double-blind controlled trial. Singapore Medical Journal. 1989;30:48–54. - PubMed
    2. Tan SL, Kee WH, Lee V, Salmon YM. The use of serratiopeptidase (Danzen) for the treatment of breast engorgement - a randomised double-blind controlled trial. Proceedings of the 24th British Congress of Obstetrics and Gynaecology; Cardiff, UK. 1986 April 15-18.1986. p. 246.
    1. King AG. Prevention of puerperal breast engorgement with large doses of long-acting estrogen. American Journal of Obstetrics and Gynecology. 1958;78:80–5. - PubMed

References to studies awaiting assessment

    1. Roberts KL, Reiter M, Schuster D. Effects of cabbage leaf extract on breast engorgement. Journal of Human Lactation. 1998;14(3):231–6. - PubMed

Additional references

    1. Acarturk S, Gensel E, Tuncer I. An uncommon complication of secondary augmentation mammoplasty: bilaterally massive engorgement of breasts after pregnancy attributable to postinfection and blockage of mammary ducts. Aesthetic Plastic Surgery. 2005;29(4):274–9. - PubMed
    1. Britton C, McCormick FM, Renfrew MJ, Wade A, King SE. Support for breastfeeding mothers. Cochrane Database of Systematic Reviews. 2007;(Issue 1) [DOI: 10.1002/14651858.CD001141.pub3] - PubMed
    1. Campbell S, Lees C. Obstetrics by 10 teachers. Arnold; London: 2000.
    1. Chopra M. Breast is best but what about HIV. MRC News. 2006 Dec;
    1. Clarke TM. [accessed 2007];Is it the flu? Recognised mastitis. http://att.iparenting.com/breastfeed/notflu.htm.

References to other published versions of this review

    1. Snowden HHM, Renfrew MJ, Woolridge M. Treatments for breast engorgement during lactation. Cochrane Database of Systematic Reviews. 2001;(Issue 2) [Art. No.: CD000046. DOI: 10.1002/14651858.CD000046.pub2] - PubMed

    1. * Indicates the major publication for the study

Publication types