Methods	Quasi-randomised trial (breasts rather than women were the unit of analysis)
Participants	34 lactating women in postnatal wards in 2 Australian hospitals with breast engorgement (hard, warm, painful breasts, difficulty feeding)
Interventions	Cabbage leaves were compared with chilled retaining gel packs. Each woman put cabbage leaves on 1 breast and a cold gel pack on the other
Outcomes	Pre and post-test pain rating for each breast rated on a “pain ruler” (a VAS with numbers from 0-10, labelled with descriptions 0 = no pain, 5 = moderate pain, and 10 = excruciating pain)
Notes	Analysis was at the breast level and results were at high risk of bias and difficult to interpret. We have not included data in the data tables
Risk of bias
Item	Authors’ judgement	Description
Adequate sequence generation?	No	Quasi randomisation (by hospital number) of right and left breasts
Allocation concealment?	No
Blinding? Women	No	Not feasible. This is particularly a problem as women received both treatments (each breast having a different treatment)
Blinding? Clinical staff	No
Blinding? Outcome assessors	No
Incomplete outcome data addressed? All outcomes	Yes	None apparent.
Free of other bias?	No	The data were analysed at the breast level with no adjustment for the non-independence of breasts