The value of swabbing sore nipples during lactation (1016.1)

Abstract

This study aimed to provide insight into nipple pain in breastfeeding mothers focusing on the microbiology, treatments and subsequent outcomes. For a 6‐month period, data were retrieved from the lactation consultant records of 489 clients of the Breast Feeding Centre of WA. Nipple pain was identified in 36% of the clients. Nipple swabs were collected from 46% of the clients with nipple pain when infection was clinically suspected as the cause. The rate of detected infection was 61%. Staphylococcus species were present in 90% of the positive cultures. Other infective organisms detected were a variant of the Streptococcus species, Acinetobacter baumannii, Pseudomonas stutzeri and Candida. Targeted treatment was provided for 77% of the mothers who were positive. Antibiotic choice included flucloxacillin alone or with a combination of other antimicrobials or antifungals, cephalexin, or cephalosporin, depending on the sensitivity of the organism grown from the swab to antibiotics. Fluconazole was prescribed when candida was detected. The treatment resulted in the nipple pain resolving or resolved in 71% of cases. We conclude that swabbing painful nipples during lactation can provide successful, targeted treatment. Grant Funding Source: Supported by Medela, AG