Case–control study of risk factors for infectious mastitis in Spanish breastfeeding women

Abstract

BackgroundThe purpose of this study was to identify potential predisposing factors associated with human infectious mastitis.MethodsWe conducted a case–control study among breastfeeding women, with 368 cases (women with mastitis) and 148 controls. Data were collected by a questionnaire designed to obtain retrospective information about several factors related to medical history of mother and infant, different aspects of pregnancy, delivery and postpartum, and breastfeeding practices that could be involved in mastitis. Bivariate analyses and multivariate logistic regression model were used to examine the relationship between mastitis and these factors.ResultsThe variables significantly- and independently-associated with mastitis were cracked nipples (P < 0.0001), oral antibiotics during breastfeeding (P < 0.0001), breast pumps (P < 0.0001), topical antifungal medication during breastfeeding (P = 0.0009), mastitis in previous lactations (P = 0.0014), breast milk coming in later than 24 h postpartum (P = 0.0016), history of mastitis in the family (P = 0.0028), mother-infant separation longer than 24 h (P = 0.0027), cream on nipples (P = 0.0228) and throat infection (P = 0.0224).ConclusionsValuable factors related to an increased risk of infectious mastitis have been identified. This knowledge will allow practitioners to provide appropriate management advice about modifiable risk factors, such as the use of pumps or inappropriate medication. They also could identify before delivery those women at an increased risk of developing mastitis, such as those having a familial history of mastitis, and thus develop strategies to prevent this condition.

Breast Pain

“…Some other reported risk factors have also been suggested such as mastitis with a prior breastfeeding experience and the use of breast pumps. 31 Culturing of human milk using molecular technology has increased our understanding of the microbial environment of the breast during lactation. Both skin and enteric-associated organisms have been identified.…”

Association between prior antibiotic therapy and subsequent risk of community-acquired infections: a systematic review

“…A full-text review was conducted of 386 publications, from which 18 met the eligibility criteria and were included in the review. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] The detailed rationale behind the exclusion of studies is presented in Figure 1.…”

“…Study sample sizes ranged from 105 24 to 164461 34 participants. In 13 studies the hypothesis that antibiotic use would increase subsequent risk of infections was not stated [19][20][21][22]24,[26][27][28]30,[32][33][34][35] and earlier antibiotic use was one of many other variables assessed as potential risk factors for infection.…”

“…18,19,23,29,31,34 Ten studies determined exposure status through participant interview or questionnaire. [20][21][22][26][27][28]30,32,33,35 One study interviewed both participants and their physician, 24 and in one study medication data was obtained from the physician only when the participant was unsure. 25 Seventeen studies defined exposure as the consumption of any antibiotic medication.…”

Mastitis. Puesta al día

“…49,50 Para estos autores, la mastitis subaguda es un cuadro de dolor intenso punzante y sensación de quemazón o calambres durante la toma o al finalizarla que puede irradiarse hacia la axila y puede acompañarse de disminución de la producción láctea. 24 El origen del dolor estaría en biofilms producidos por bacterias (principalmente, SCN) dentro de los conductos galactóforos, que reducirían su luz y aumentarían la presión de la leche en el momento de la eyección. Si la obstrucción se hace total, aparece la "ampolla o perla de leche", tapón formado por bacterias y calcio.…”