 In response to a photo showing a woman taping a cabbage leaf onto her knee to help with her osteoarthritis, doctors wrote in asserting that cabbage leaves can help inflammation of any body part. You may even find that there's a cache of cabbage in the fridge of your local maternity unit. Why? Well, not only is cabbage cheaper than gel packs, but knees are not the only anatomical shapes that the leaves can form well to. Breast engorgement, when the breasts become overfilled with milk during breastfeeding, becoming hard, tight, and painful, can negatively impact both mother and infant alike. So why not put cabbage leaves on them? A lactation consultant in a breastfeeding journal suggests wearing cabbage leaves. Evidently, it works like a charm, and once the swelling goes down, frequent breastfeeding should help them from refilling up too much. Where did she even get the idea for this? Well, her son got in a car accident, she wrapped his leg in cabbage, and the rest is history. The only adverse side effect identified was a complaint from the son who felt like a vegetable. Based on the information she collected, she concluded that cool green cabbage compresses have anti-inflammatory, anti-edema, anti-swelling, and anti-infectious properties, but you don't really know until you put it to the test. Yeah, but who's got to do a randomized controlled study of cabbage leaves? Scientists, that's who. Do cabbage leaves prevent breast engorgement? Let's find out. 120 women are randomized to apply cabbage leaves to their breasts or not, and though the cabbage group tended to report less breast engorgement, the trend was not statistically significant, though one of the big things you care about is premature weaning, and the cabbage group did seem to be able to extend the time they were exclusively breastfeeding. So while they couldn't rule out the possibility that cabbage leaves had a direct effect on breast engorgement that may have contributed to the increased breastfeeding success in the experimental group, they consider the positive effect to be more likely due to psychological mechanisms. In other words, the placebo effect. They did weed out some of the true believers, though, as some women refused to join the study out of fury they might end up in the control group and not be able to use them. A similar study, performed recently, found that while adding cabbage leaves to early breast care didn't significantly reduce pain, it did seem to significantly reduce breast hardness. Since it probably can't hurt, some women might want to just give it a try. But it would be nice to get some more concrete answers. Like how about a treatment trial instead of just prevention? You could try hot cabbage leaves versus cold cabbage leaves. To control for the placebo effect, you could use placebo cabbage, like iceberg lettuce leaves or something. In fact, since both breasts are affected, women could act as their own controls, cabbage on one breast and turning over a new leaf on the other. How about a comparison of chilled cabbage leaves versus chilled gel packs, just cold alone? Decreases blood flow, might therefore decrease engorgement. On the other hand, maybe cabbage leaves contain some component that the mother's skin absorbs that somehow helps. You don't know until you put it to the test. 34 lactating women with breast engorgement. One breast got the cabbage, one breast got the gel pack. Their pain levels were established before and after, and there was no difference. They both appeared to work about just as well, with two-thirds reporting relief within hours, either way. Though interestingly, the majority of mothers preferred the cabbage leaves. The similarity in the effect may have been caused by the fact that both applied cold, although you'd think the effects of the cold of the cabbage leaves would have been transitory. So hey, maybe there is something special in cabbage leaves after all. What you'd have to do is like a comparison of chilled versus room temperature cabbage. Okay, here you go. One breast gets the chilled cabbage leaf, and the other gets a room temperature cabbage leaf, and there was no difference between the two. They both seemed to work, suggesting that it's not the cold itself that's doing it, but we still don't know what the role of the placebo effect is playing. If you were going to design a study to determine if there was some special compound in cabbage that could decrease breast engorgement, what would you do? I mean, you could try the iceberg lettuce, but you know, if women heard about the cabbage effect, they might have an expectation bias in favor of the cabbage. Ah-ha! How about using a cabbage leaf extract? Then you can finally do a double-blind experiment where women don't know which breasts are exposed to the cabbage by asking them to rub on a cream containing a cabbage leaf extract versus a placebo cream. They added rose water to both creams to try to camouflage any residual cabbage odor, and no difference in relief. Now the decrease in discomfort produced by the cream was not as strong as that produced by the real cabbage leaves in the previous studies. The superiority of the whole leaves might be explained by a failure of the extract to contain the potentially active chemical, or maybe the chemical broke down, or maybe it wasn't concentrated enough, or maybe there was just a powerful placebo effect of wearing cabbage leaves. The bottom line is that even though no active pharmacological substances in cabbage leaves have been identified, the convenient shape of cabbage leaves their low cost, wide availability, and purported soothing effect make it a sought-after treatment.