RESUMO
Aim: To study effect of cabbage compresses versus manual pumping in relieving breast engorgement
Study Question: Which is best in relieving breast engorgement cabbage compresses or manual pumping?
Justification: Breast engorgement is a common problem affecting many of women especially during early post partum period. It leads to breast pains that limit spontaneity of breast feeding a condition negatively impacting general well being of both mother and neonate. Some women find difficulty in using and tolerating manual breast pumping. Green Cabbage being cheep, natural and available in women houses was simply used to reduce swelling. Many of the published studies supported its value in reducing breast engorgement .So its validity compared to other commonly used methods as manual pump need to be objectively studied. A comparative, quasi-experimental study had been done at the fourth stage of labor ward and postnatal follow up clinic of Ain Shams Maternity University Hospital. Two hundred thirty nine women before being discharged from labor ward and fulfilling the study criteria were conveniently selected, and agreed to be included in the study. Inclusion criteria included, primepares, age between 20-35 years, can read and write, normally breast feed their normally delivered single, full term babies. Both women and babies were medically examined and identified as being free from any primary condition interfere with breast feeding process. Women were allocated according to their wishes to either using green cabbage compresses group [122 women] or manual pumping group [117 women] to relieve any engorgement affecting their breasts in the two weeks following their child birth. Women were followed for occurrence of breast engorgement and for practicing times per day, practicing minutes per time and period of using the selected relive method signs of being relived from engorgement by telephone contact and during postpartum follow up visits in out patient clinic. The following tools were used for data collection: Structured Interviewing Questionnaire, Engorgement scale, dairy, Visual Analogue Scale for breast pain assessment. Written instructions were given to women after individual teaching of preventative measures and either cabbage compresses or manual pump procedure. Pilot study had been done on 30 women, tools and data collection plane were modified according to its results and women included in the pilot were excluded from the study. Either Women or babies exposed to any condition interfere with breast feeding process during the study period were excluded
Results: proved that both methods are effective in reliving breast engorgement, however women used cabbage compresses were recovered faster than those used pumping with mean recovery days of 2.5 +/- 0.1, 3.5 +/- 0.4 day respectively, women satisfied with cabbage compresses represented 83.3%, this led to maximum exposure to the method as they were instructed, while satisfaction of women used manual pumping represented 30.8%. Women explained this limited percent by difficulty of its use and pain associated with practice that led to interrupted pumping manner. Daily progress in both methods was statistically significant, with more rapid progress percent among women used cabbage compresses. The progress days in both methods was dependent on the practicing times per day and practicing minutes per each time as an inverse correlation was proven between these variables, as the more practicing times and exposure minutes the less recovery days. Results thought light up importance of educating pregnant and laboring women about preventive and relive methods of breast engorgement that could be safely practiced at home. Limitations of the study included missing some women from the study as a result of their inaccurate registration to their phone number as well as ignoring post partum follow up visits. Also some women were excluded due to affection of their babies by conditions limited breast feeding process during the study period, these factors decreased sample size