Study Shows Marshmallow Leaf Eases Postpartum Pain

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In this study, researchers from Iran studied CAM therapy using Althaea officinalis (L.) leaf. The study looked at 48 mothers suffering from engorged breasts in a randomized, controlled clinical trial, which was conducted in Hazrat Abolfazl Hospital and other health centers in Kashmar, Iran. The study aimed to find if warm hollyhock leaf compresses combined with cold compresses could ease engorgement in lactating women. It is important to note that the authors of this study refer to Althaea officinalis (L.) by its common name, hollyhock, but in the United States, we most usually refer to this plant as marshmallow.

The criteria for inclusion in this study required the lactating mothers to be within 1-15 days postpartum, have breast engorgement with a minimum score of 2 according to the checklist provided to them, a temperature below 38°C, an ability to breastfeed every 2-3 hours, and a history free of breast abscesses and mastitis. She was to be free from allergies to Althaea officinalis (L.) as well. Infants had to be full-term with a normal birth weight, able to suck, and able to breastfeed every 2-3 hours.

Althaea officinalis (L.) leaves and stems were dried at 60°C for 24 hours and ground to a powder. They were then irradiated with ultraviolet light for 30 minutes in an attempt to prevent infections. The herbal compresses were prepared by using 10 grams of the Althaea officinalis (L.) powder and mixing it with cool water that had previously been boiled. The solution was ready to use within 30 minutes. Cold compresses were also made and kept separate from the warm compresses.

Participants were instructed on how to perform the compresses at their homes and how to assess the severity of their breast engorgement. In the control group, the lactating mothers were instructed to apply a warm compress (43°C to 46°C) without Althaea officinalis (L.) to the engorged breast for 2 minutes before breastfeeding. She was then to remove the compress, wait half an hour, and then breastfeed her child while massaging the engorged breast from its top to the nipple. After breastfeeding, a cold compress (10°C to 18°C) was to be applied for 15-20 minutes. During both the warm and cold compress applications, the compress was resoaked in the water every 2 minutes to maintain temperature. After each time, the mother was to assess and record the breast engorgement severity.

The same procedure was followed in the intervention group, but after 10 to 15 minutes, 40-50 mL of Althaea officinalis (L.) herbal compress was rubbed onto the mother’s breast and then removed within 10 minutes.

Both groups repeated these procedures three times a day for two consecutive days. If the mother’s breast engorgement severity reached zero before the completion of six procedures, the intervention was stopped. During the two-day period, participants were told to nurse their infants from both breasts every 2 to 3 hours for 10 to 15 minutes.

​Both the control and intervention groups experienced a decrease in breast engorgement severity. However, the intervention group, which received hollyhock leaf compresses, showed significantly greater improvement (P < .001). This suggests that incorporating hollyhock leaf compresses may enhance the effectiveness of standard interventions for breast engorgement.

While direct comparisons to similar studies cannot be made at this time due to a lack of prior research, existing literature supports hollyhock's softening, anti-inflammatory, and immune-stimulating properties. These therapeutic actions potentially support Althaea officinalis (L.) compresses as a viable CAM therapy for engorged breasts.

In summary, hollyhock leaf compresses appear to be a safe remedy for both mother and baby to speed up the relief from engorged breasts. Due to the limitations of this study, further studies are recommended.

Reference

Khosravan, S., Mohammadzadeh-Moghadam, H., Mohammadzadeh, F., Fadafen, S. A. K., & Gholami, M. (2016). The Effect of Hollyhock (Althaea officinalis L) Leaf Compresses Combined With Warm and Cold Compress on Breast Engorgement in Lactating Women. Journal of Evidence-Based Complementary & Alternative Medicine, 22(1), 25–30. https://doi.org/10.1177/2156587215617106