• Ertitawai Siregar Master of Applied Science in Midwifery, Poltekkes Kemenkes Semarang, Semarang, Indonesia
  • Triana Sri Hardjanti Master of Applied Science in Midwifery, Poltekkes Kemenkes Semarang, Semarang, Indonesia


Background:. Mothers often suffer breast engorgement at the beginning of postpartum, and one of the causes is early breastfeeding cessation. Management of breast engorgement should be done well to support the success of exclusive breastfeeding. This study aimed to review and identify the nonpharmacological treatments that have potential effects on reduced breast engorgement

Methods:This was a systematic review prepared according to the standard guidelines of the Joanna Briggs Institute (JBI). Article search used electronically. The two databases used were the PubMed and Cochrane library. English-language articles, and full text using the keywords of "treatment breast engorgement” OR “lactating” OR “cabbage compress". The inclusion criteria were the studies with Randomized controlled trial (RCT) published from 2009 to 2019, the respondents were postpartum mothers who breastfed their babies, and intervention was non-pharmacological action research and not a medical action.

Results: Out of 5,927 articles resulted from the literature search, there were 5 articles that met the inclusion criteria and included in this systematic review with a total number of 882 participants. The treatment used in dealing with breast engorgement varied, such as 2 studies used cold cabbage leaf and the remaining studies used these non-pharmacological treatments, respectively: hot herbal compresses, cold hollyhock herbal compress, the intervention of Gua sha. All the results of the study stated that the intervention was effective in reducing breast pain and engorgement.

Conclusions: Herbal compresses, leaf compresses hollyhock, cabbage compresses and Gua sha therapy can be used to treat breast engorgement during lactation, but more rigorous follow-up studies are needed to see which interventions are most effective using larger samples.

Keywords: Breast engorgement, breastfeeding, a non-pharmacological, systematic review


Andreas NJ, Kampmann B, Mehring Le-Doare K. Human breast milk: A review on its composition and bioactivity. Early Human Development 2015; 91: 629–635.

Lawrence RM, College F. Safety of Human Milk : Microbiological Aspects. Elsevier Ltd. Epub ahead of print 2014. DOI: 10.1016/B978-0-12-378612-8.00323-1.

Economou M, Kolokotroni O, Paphiti-Demetriou I, et al. Prevalence of breast-feeding and exclusive breast-feeding at 48 h after birth and up to the sixth month in Cyprus: The BrEaST start in life project. Public Health Nutr 2018; 21: 967–980.

Strong GD. Provider Management and Support for Breastfeeding Pain. JOGNN - J Obstet Gynecol Neonatal Nurs 2011; 40: 753–764.

Santos KJ da S, Santana GS, Vieira T de O, et al. Prevalence and factors associated with cracked nipples in the first month postpartum. BMC Pregnancy Childbirth 2016; 16: 1–8.

Li R, Odom EC, Perrine CG, et al. Reasons for Earlier Than Desired Cessation of Breastfeeding. Pediatrics 2013; 131: e726–e732.

Karaçam Z, Sağlık M. Breastfeeding problems and interventions performed on problems : systematic review based on studies made in Turkey. Epub ahead of print 2018. DOI: 10.5152/TurkPediatriArs.2018.6350.

Leung SSF. Breast pain in lactating mothers. 2016; 22: 341–346.

Mangesi L, Dowswell T. Treatments for breast engorgement during lactation ( Review ).

Neville MC, Keller R, Seacat J, et al. Studies in human lactation: Milk volumes in lactating women during the onset of lactation and full lactation. Am J Clin Nutr 1988; 48: 1375–1386.

Alekseev NP, Vladimir II, Nadezhda TE. Pathological Postpartum Breast Engorgement: Prediction, Prevention, and Resolution. Breastfeed Med 2015; 10: 203–208.

Alekseev NP. Does Not Eliminate Postpartum Breast Engorgement ? Breastfeed Med 2017; 12: 2–3.

Chapman DJ. Evaluating the Evidence: Is There an Effective Treatment for Breast Engorgement? J Hum Lact 2011; 27: 82–83.

Mangesi L. Treatments for breast engorgement during lactation ( Review ). Epub ahead of print 2016. DOI: 10.1002/

Ketsuwan S, Baiya N, Paritakul P, et al. Effect of Herbal Compresses for Maternal Breast Engorgement at Postpartum: A Randomized Controlled Trial. Breastfeed Med 2018; 13: 361–365.

Wong BB, Chan YH, Leow MQH, et al. Application of cabbage leaves compared to gel packs for mothers with breast engorgement: Randomised controlled trial. Int J Nurs Stud 2017; 76: 92–99.

Khosravan S, Mohammadzadeh-Moghadam H, Mohammadzadeh F, et al. The Effect of Hollyhock (Althaea officinalis L) Leaf Compresses Combined With Warm and Cold Compress on Breast Engorgement in Lactating Women: A Randomized Clinical Trial. J Evidence-Based Complement Altern Med 2017; 22: 25–30.

Lim A, Song J, Hur M, et al. Cabbage compression early breast care on breast engorgement in primiparous women after cesarean birth : a controlled clinical trial. Int J Clin Exp Med 2015; 8: 21335–21342.

Chiu J-Y, Gau M-L, Kuo S-Y, et al. Effects of Gua-Sha therapy on breast engorgement: a randomized controlled trial. J Nurs Res 2010; 18: 1–10.

Saini R, Saini P. Cabbage leaves and breast engorgement. Indian J Public Health 2014; 58: 291.

Nikodem VC, Rmrn C, Danziger D, et al. Do Cabbage Leaves Prevent Breast Engorgement ? A Randomized , Controlled Study. 1993; 61–64.

Rgn LJK, Rn BWL, Rn MLH, et al. Effects of acupuncture and care interventions on the outcome of inflammatory symptoms of the breast in lactating women. 2004; 56–64.

Kvist LJ, Louise Hall-Lord M, Rydhstroem H, et al. 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: 184–195.

Rokayya S, Li C, Zhao Y, et al. Cabbage ( Brassica oleracea L . var . capitata ) Phytochemicals with Antioxidant and Anti-inflammatory Potential. 2013; 14: 6657–6662.

Hanna Szaefer, Violetta Krajka-Kuźniak, Barbara Licznerska AB& WB-D. Cabbage Juices and Indoles Modulate the Expression Profile of AhR, ERα, and Nrf2 in Human Breast Cell Lines. Nutr Cancer 2015; 1–13.

Boi B, Srn W, Nursing B. The effectiveness of cabbage leaf application ( treatment ) on pain and hardness in breast engorgement and its effect on the duration of breastfeeding. JBI Libr Syst Rev 2012; 10: 1185–1213.

Arora S, Manju V, Vatsia D. A comparison of cabbage leaves vs . hot and cold compresses in the treatment of breast engorgement. Indian J Community Med 2008; 33: 160–162.

Witt AM, Bolman M, Kredit S, et al. Therapeutic Breast Massage in Lactation for the Management of Engorgement, Plugged Ducts, and Mastitis. J Hum Lact 2016; 32: 123–131.

Bolman M, Saju L, Oganesyan K, et al. Recapturing the art of therapeutic breast massage during breastfeeding. J Hum Lact 2013; 29: 328–331.

Mannel R, Dixon I. Overly Full Breasts (Engorgement). J Hum Lact 2014; 30: 369–370.

Chongmelaxme B, Sruamsiri R, Dilokthornsakul P, et al. Clinical effects of Zingiber cassumunar (Plai): A systematic review. Complement Ther Med 2017; 35: 70–77.

Manimmanakorn N, Manimmanakorn A, Boobphachart D, et al. Effects of Zingiber cassumunar (Plai cream) in the treatment of delayed onset muscle soreness. J Integr Med 2016; 14: 114–120.

Nielsen A, Kligler B, Koll BS. Safety protocols for Gua sha (press-stroking) and Baguan (cupping). Complement Ther Med 2012; 20: 340–344.

Lam CT, Tse SH, Chan ST, et al. A survey on the prevalence and utilization characteristics of gua sha in the Hong Kong community. Complement Ther Med 2015; 23: 46–54.

Meng F, Duan PB, Zhu J, et al. Effect of Gua sha therapy on perimenopausal syndrome: A randomized controlled trial. Menopause 2016; 24: 299–307.



How to Cite

Siregar, E., & Hardjanti, T. S. (2019). NON PHARMACOLOGICAL TREATMENTS FOR BREAST ENGORGEMENT: A SYSTEMATIC REVIEW. Proceedings of the International Conference on Applied Science and Health, (4), 492–502. Retrieved from