Skip to main content
Top
Published in: BMC Public Health 1/2007

Open Access 01-12-2007 | Research article

A descriptive study of mastitis in Australian breastfeeding women: incidence and determinants

Authors: Lisa H Amir, Della A Forster, Judith Lumley, Helen McLachlan

Published in: BMC Public Health | Issue 1/2007

Login to get access

Abstract

Background

Mastitis is one of the most common problems experienced by women who are breastfeeding. Mastitis is an inflammation of breast tissue, which may or may not result from infection. The aims of this paper are to compare rates of mastitis in primiparous women receiving public hospital care (standard or birth centre) and care in a co-located private hospital, and to use multivariate analysis to explore other factors related to mastitis.

Methods

Data from two studies (a randomised controlled trial [RCT] and a survey) have been combined. The RCT (Attachment to the Breast and Family Attitudes to Breastfeeding, ABFAB) which was designed to test whether breastfeeding education in mid-pregnancy could increase breastfeeding duration recruited public patients at the Royal Women's Hospital at 18–20 weeks gestation. A concurrent survey recruited women planning to give birth in the Family Birth Centre (at 36 weeks gestation) and women in the postnatal wards of Frances Perry House (private hospital). All women were followed up by telephone at 6 months postpartum. Mastitis was defined as at least 2 breast symptoms (pain, redness or lump) AND at least one of fever or flu-like symptoms.

Results

The 6 month telephone interview was completed by 1193 women. Breastfeeding rates at 6 months were 77% in Family Birth Centre, 63% in Frances Perry House and 53% in ABFAB. Seventeen percent (n = 206) of women experienced mastitis. Family Birth Centre and Frances Perry House women were more likely to develop mastitis (23% and 24%) than women in ABFAB (15%); adjusted odds ratio (Adj OR) ~1.9. Most episodes occurred in the first 4 weeks postpartum: 53% (194/365). Nipple damage was also associated with mastitis (Adj OR 1.7, 95% CI, 1.14, 2.56). We found no association between breastfeeding duration and mastitis.

Conclusion

The prevention and improved management of nipple damage could potentially reduce the risk of lactating women developing mastitis.

Trial registration

Trial registration (ABFAB): Current Controlled Trials ISRCTN21556494
Appendix
Available only for authorised users
Literature
1.
go back to reference World Health Organization: Mastitis: Causes and Management. 2000, Geneva , WHO/FCH/ CAH/00.13 World Health Organization: Mastitis: Causes and Management. 2000, Geneva , WHO/FCH/ CAH/00.13
2.
go back to reference Donath SM, Amir LH: Breastfeeding and the introduction of solids in Australian children: data from the 2001 National Health Survey. Aust N Z J Public Health. 2005, 29 (2): 171-175.CrossRefPubMed Donath SM, Amir LH: Breastfeeding and the introduction of solids in Australian children: data from the 2001 National Health Survey. Aust N Z J Public Health. 2005, 29 (2): 171-175.CrossRefPubMed
3.
go back to reference Brown S, Lumley J: Maternal health after childbirth: results of an Australian population based survey. Br J Obstet Gynaecol. 1998, 105 (2): 156-161.CrossRefPubMed Brown S, Lumley J: Maternal health after childbirth: results of an Australian population based survey. Br J Obstet Gynaecol. 1998, 105 (2): 156-161.CrossRefPubMed
4.
go back to reference Kinlay JR, O'Connell DL, Kinlay S: Incidence of mastitis in breastfeeding women during the six months after delivery: a prospective cohort study. Med J Aust. 1998, 169 (6): 310-312.PubMed Kinlay JR, O'Connell DL, Kinlay S: Incidence of mastitis in breastfeeding women during the six months after delivery: a prospective cohort study. Med J Aust. 1998, 169 (6): 310-312.PubMed
5.
go back to reference Thompson JF, Roberts CL, Currie M, Ellwood DA: Prevalence and persistence of health problems after childbirth: associations with parity and method of birth. Birth. 2002, 29 (2): 83-94. 10.1046/j.1523-536X.2002.00167.x.CrossRefPubMed Thompson JF, Roberts CL, Currie M, Ellwood DA: Prevalence and persistence of health problems after childbirth: associations with parity and method of birth. Birth. 2002, 29 (2): 83-94. 10.1046/j.1523-536X.2002.00167.x.CrossRefPubMed
6.
go back to reference Foxman B, D'Arcy H, Gillespie B, Bobo JK, Schwartz K: Lactation mastitis: occurrence and medical management among 946 breastfeeding women in the United States. Am J Epidemiol. 2002, 155 (2): 103-114. 10.1093/aje/155.2.103.CrossRefPubMed Foxman B, D'Arcy H, Gillespie B, Bobo JK, Schwartz K: Lactation mastitis: occurrence and medical management among 946 breastfeeding women in the United States. Am J Epidemiol. 2002, 155 (2): 103-114. 10.1093/aje/155.2.103.CrossRefPubMed
7.
go back to reference Nicholson W, Yuen HP: A study of breast feeding rates at a large Australian obstetric hospital. Aust N Z J Obstet Gynaecol. 1995, 35 (4): 393-397.CrossRefPubMed Nicholson W, Yuen HP: A study of breast feeding rates at a large Australian obstetric hospital. Aust N Z J Obstet Gynaecol. 1995, 35 (4): 393-397.CrossRefPubMed
8.
go back to reference Kaufmann R, Foxman B: Mastitis among lactating women: occurrence and risk factors. Soc Sci Med. 1991, 33 (6): 701-705. 10.1016/0277-9536(91)90024-7.CrossRefPubMed Kaufmann R, Foxman B: Mastitis among lactating women: occurrence and risk factors. Soc Sci Med. 1991, 33 (6): 701-705. 10.1016/0277-9536(91)90024-7.CrossRefPubMed
9.
go back to reference Waldenstrom U, Nilsson CA: No effect of birth centre care on either duration or experience of breast feeding, but more complications: findings from a randomised controlled trial. Midwifery. 1994, 10 (1): 8-17. 10.1016/0266-6138(94)90004-3.CrossRefPubMed Waldenstrom U, Nilsson CA: No effect of birth centre care on either duration or experience of breast feeding, but more complications: findings from a randomised controlled trial. Midwifery. 1994, 10 (1): 8-17. 10.1016/0266-6138(94)90004-3.CrossRefPubMed
10.
go back to reference Scott JA, Binns CW: Factors associated with the initiation and duration of breastfeeding: a review of the literature. Aust J Nutr Diet. 1998, 55 (2): 51-61. Scott JA, Binns CW: Factors associated with the initiation and duration of breastfeeding: a review of the literature. Aust J Nutr Diet. 1998, 55 (2): 51-61.
11.
go back to reference Forster D, McLachlan H, Lumley J, Beanland C, Waldenstrom U, Amir L: Two mid-pregnancy interventions to increase the initiation and duration of breastfeeding: a randomized controlled trial. Birth. 2004, 31 (3): 176-182. 10.1111/j.0730-7659.2004.00302.x.CrossRefPubMed Forster D, McLachlan H, Lumley J, Beanland C, Waldenstrom U, Amir L: Two mid-pregnancy interventions to increase the initiation and duration of breastfeeding: a randomized controlled trial. Birth. 2004, 31 (3): 176-182. 10.1111/j.0730-7659.2004.00302.x.CrossRefPubMed
12.
go back to reference Forster D, McLachlan H, Lumley J, Beanland C, Waldenström U, Harris H, Earl D, Dyson K: Study protocol. ABFAB. Attachment to the breast and family attitudes to breastfeeding. The effect of breastfeeding education in the middle of pregnancy on the initiation and duration of breastfeeding: a randomised controlled trial [ISRCTN21556494]. BMC Pregnancy Childbirth. 2003, 3 (1): 5-10.1186/1471-2393-3-5.CrossRefPubMedPubMedCentral Forster D, McLachlan H, Lumley J, Beanland C, Waldenström U, Harris H, Earl D, Dyson K: Study protocol. ABFAB. Attachment to the breast and family attitudes to breastfeeding. The effect of breastfeeding education in the middle of pregnancy on the initiation and duration of breastfeeding: a randomised controlled trial [ISRCTN21556494]. BMC Pregnancy Childbirth. 2003, 3 (1): 5-10.1186/1471-2393-3-5.CrossRefPubMedPubMedCentral
13.
go back to reference Forster D, McLachlan H, Lumley J: Factors associated with continuing to feed any breast milk at six months postpartum in a group of Australian women. Int Breastfeed J. 2006, 1: 18-10.1186/1746-4358-1-18.CrossRefPubMedPubMedCentral Forster D, McLachlan H, Lumley J: Factors associated with continuing to feed any breast milk at six months postpartum in a group of Australian women. Int Breastfeed J. 2006, 1: 18-10.1186/1746-4358-1-18.CrossRefPubMedPubMedCentral
14.
go back to reference Last JM: A Dictionary of Epidemiology. 2001, New York , Oxford University Press, 4th Last JM: A Dictionary of Epidemiology. 2001, New York , Oxford University Press, 4th
15.
go back to reference Amir LH, Forster D, McLachlan H, Lumley J: Incidence of breast abscess in lactating women: report from an Australian cohort. BJOG. 2004, 111 (12): 1378-1381. 10.1111/j.1471-0528.2004.00272.x.CrossRefPubMed Amir LH, Forster D, McLachlan H, Lumley J: Incidence of breast abscess in lactating women: report from an Australian cohort. BJOG. 2004, 111 (12): 1378-1381. 10.1111/j.1471-0528.2004.00272.x.CrossRefPubMed
16.
go back to reference Hosmer DW, Lemeshow S: Applied Logistic Regression. 2000, New York , John Wiley & Sons, Inc., 2nd EdCrossRef Hosmer DW, Lemeshow S: Applied Logistic Regression. 2000, New York , John Wiley & Sons, Inc., 2nd EdCrossRef
17.
go back to reference Department of Human Services Victoria: Maternal and Child Health Statewide Data Report 2000-2001. 2002, Melbourne Department of Human Services Victoria: Maternal and Child Health Statewide Data Report 2000-2001. 2002, Melbourne
18.
go back to reference Fetherston C: Mastitis in lactating women: physiology or pathology?. Breastfeed Rev. 2001, 9 (1): 5-12.PubMed Fetherston C: Mastitis in lactating women: physiology or pathology?. Breastfeed Rev. 2001, 9 (1): 5-12.PubMed
19.
go back to reference Fetherston C: Characteristics of lactation mastitis in a Western Australian cohort. Breastfeed Rev. 1997, 5 (2): 5-11.PubMed Fetherston C: Characteristics of lactation mastitis in a Western Australian cohort. Breastfeed Rev. 1997, 5 (2): 5-11.PubMed
20.
go back to reference Vogel A, Hutchison BL, Mitchell EA: Mastitis in the first year postpartum. Birth. 1999, 26 (4): 218-225. 10.1046/j.1523-536x.1999.00218.x.CrossRefPubMed Vogel A, Hutchison BL, Mitchell EA: Mastitis in the first year postpartum. Birth. 1999, 26 (4): 218-225. 10.1046/j.1523-536x.1999.00218.x.CrossRefPubMed
21.
go back to reference Brown S, Bruinsma F, Darcy MA, Small R, Lumley J: Early discharge: no evidence of adverse outcomes in three consecutive population-based Australian surveys of recent mothers, conducted in 1989, 1994 and 2000. Paediat Perinat Epidemiol. 2004, 18 (3): 202-213. 10.1111/j.1365-3016.2004.00558.x.CrossRef Brown S, Bruinsma F, Darcy MA, Small R, Lumley J: Early discharge: no evidence of adverse outcomes in three consecutive population-based Australian surveys of recent mothers, conducted in 1989, 1994 and 2000. Paediat Perinat Epidemiol. 2004, 18 (3): 202-213. 10.1111/j.1365-3016.2004.00558.x.CrossRef
22.
go back to reference Foxman B, Schwartz K, Looman SJ: Breastfeeding practices and lactation mastitis. Soc Sci Med. 1994, 38 (5): 755-761. 10.1016/0277-9536(94)90466-9.CrossRefPubMed Foxman B, Schwartz K, Looman SJ: Breastfeeding practices and lactation mastitis. Soc Sci Med. 1994, 38 (5): 755-761. 10.1016/0277-9536(94)90466-9.CrossRefPubMed
23.
go back to reference Fetherston C: Risk factors for lactation mastitis. J Hum Lact. 1998, 14 (2): 101-109. 10.1177/089033449801400209.CrossRefPubMed Fetherston C: Risk factors for lactation mastitis. J Hum Lact. 1998, 14 (2): 101-109. 10.1177/089033449801400209.CrossRefPubMed
24.
go back to reference Kinlay JR, O'Connell DL, Kinlay S: Risk factors for mastitis in breastfeeding women: results of a prospective cohort study. Aust N Z J Public Health. 2001, 25 (2): 115-120.CrossRefPubMed Kinlay JR, O'Connell DL, Kinlay S: Risk factors for mastitis in breastfeeding women: results of a prospective cohort study. Aust N Z J Public Health. 2001, 25 (2): 115-120.CrossRefPubMed
Metadata
Title
A descriptive study of mastitis in Australian breastfeeding women: incidence and determinants
Authors
Lisa H Amir
Della A Forster
Judith Lumley
Helen McLachlan
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2007
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-7-62

Other articles of this Issue 1/2007

BMC Public Health 1/2007 Go to the issue