Literature review for - Flourish Paediatrics

The cross-sectional study conducted in Hong Kong assessed 7298 mother’s concerns about
breastfeeding. Of the mothers whose infants were less than 6 months of age (n=3161), 44.2%
of them reported they had breast engorgement and leakage while breastfeeding and
considered their engorgement a concern that deterred them from continued breastfeeding. The
proportion of mothers reporting engorgement was consistent between infants aged 0-5
months. At 5 months 42.3% of mothers still experienced engorgement (Lee, Lui et al. 2006).
ABM recommendations for engorgement
No evidence base was developed for the prevention of engorgement due to the lack of quality
studies.
The ABM clinical guideline states there is no significant difference in the incidence of
engorgement when mother received information regarding breastfeeding position and
attachment or prenatal nipple conditioning. Certain breastfeeding techniques have been
associated with a reduced incidence of engorgement, including emptying one breast at each
feeding and varying which breast is offered first. There is insufficient evidence that
massaging the breast after feeds in the first 4 days postpartum will lessen the extent of
engorgement. Frequent breastfeeding is advocated for the prevention of engorgement,
however, the effect of feeding frequency on engorgement has not been thoroughly researched
(Berens 2009).
In regards to treatment the ABM’s clinical protocol on engorgement basis their
recommendations on the 2001 Cochrane review on treatment of engorgement (Snowden,
Renfrew et al. 2001). The ABM concludes that there is no benefit for the following
treatments as compared with placebo; cabbage leaves, cabbage leaf extract, oxytocin, cold
packs, and ultrasound (Berens 2009) .
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