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.
Highlights
The purpose of this study was to identify potential predisposing factors associated with human infectious mastitis
Subject selection Cases (n = 368) who participated in this retrospective case–control study by filling out a questionnaire about mastitis risk factors, were recruited from 1080 lactating women with clinical symptoms of infectious mastitis who attended our laboratory from September 2009 to June 2011 to have a breast milk sample analyzed in the context of a study about microbiology of human mastitis
Among other aspects of pregnancy, delivery and postpartum, Caesarean delivery and antibiotherapy during delivery as well as the use of epidural analgesia in labor were more frequently reported by mothers with mastitis, these factors were not included in the final model obtained after the multivariable analysis
Summary
The purpose of this study was to identify potential predisposing factors associated with human infectious mastitis. Infectious mastitis is a common condition that affects up to 33% of women during lactation, its incidence may be underestimated because of differences in case definition and reporting [1,2,3,4]. As it has recently been addressed [5], most of the studies have not reported the true mastitis incidence to date, since it would be necessary to define a time limit for the collection of data and to know the size of the population at risk, that is, breastfeeding mothers in the area of study. Risk factors that have been suggested to be strongly associated to mastitis include, among others, mastitis with a previous child, cracked or sore nipples, use of ointments, inappropriate breastfeeding practices, and peripartum antibiotherapy [1,4,13,14,15]
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