Interventions for preventing mastitis after childbirth

Abstract

There was insufficient evidence to show effectiveness of any of the interventions, including breastfeeding education, pharmacological treatments and alternative therapies, regarding the occurrence of mastitis or breastfeeding exclusivity and duration. While studies reported the incidence of mastitis, they all used different interventions. Caution needs to be applied when considering the findings of this review as the conclusion is based on studies, often with small sample sizes. An urgent need for further adequately powered research is needed into this area to conclusively determine the effectiveness of these interventions.

Incidence of and Risk Factors for Lactational Mastitis: A Systematic Review

“…Many of the risk factors mentioned in this review appear amenable to mediation by women’s breastfeeding behavior and practices. A recent Cochrane review of five randomized controlled trials of interventions for preventing mastitis found no significant difference in mastitis incidence between women who received and did not receive the intervention ( Crepinsek et al, 2012 ). These trials included both use of antibiotics, as well as education and use of breastfeeding techniques to reduce the risk of mastitis; however, the reviewed studies were small and of poor methodological quality.…”

Incidence of and Risk Factors for Lactational Mastitis: A Systematic Review

“…Many of the risk factors mentioned in this review appear amenable to mediation by women’s breastfeeding behavior and practices. A recent Cochrane review of five randomized controlled trials of interventions for preventing mastitis found no significant difference in mastitis incidence between women who received and did not receive the intervention ( Crepinsek et al, 2012 ). These trials included both use of antibiotics, as well as education and use of breastfeeding techniques to reduce the risk of mastitis; however, the reviewed studies were small and of poor methodological quality.…”

A mutation in the viral sensor 2’-5’-oligoadenylate synthetase 2 causes failure of lactation

“…For example, in women the severity of symptoms of mastitis do not correlate with the level of bacterial infection, the disease is often observed in the absence of bacteria in the milk, bacteria are often found in the milk of healthy mothers, and meticulous hygiene or prophylactic antibiotics do not prevent mastitis (reviewed [ 13 ]). Recent Cochrane Systematic Reviews concluded that there is insufficient evidence to support antibiotic use for the prevention [ 14 ] or treatment [ 15 ] of mastitis. The strongest risk factors for mastitis in women involve incomplete or interrupted milk flow from one or more galactophores [ 13 ] and the World Health Organization recognizes milk stasis as the cause of mastitis [ 16 ].…”

Study protocol: evaluation of the probiotic Lactobacillus Fermentum CECT5716 for the prevention of mastitis in breastfeeding women: a randomised controlled trial

“…Although the Cochrane review reported an overall 57% non-significant reduction in mastitis [24], with individual trials finding an up to 76% reduced risk [25], we chose a more conservative 50% reduction as a clinically meaningful treatment effect. Based on an expected rate of mastitis in the control group of 18% [9–11], two-sided 5% significance level and a power of 80%, we estimated a total sample size of 452 would be required.…”

Incidence of and Risk Factors for Lactational Mastitis: A Systematic Review

“…Many of the risk factors mentioned in this review appear amenable to mediation by women’s breastfeeding behavior and practices. A recent Cochrane review of five randomized controlled trials of interventions for preventing mastitis found no significant difference in mastitis incidence between women who received and did not receive the intervention ( Crepinsek et al, 2012 ). These trials included both use of antibiotics, as well as education and use of breastfeeding techniques to reduce the risk of mastitis; however, the reviewed studies were small and of poor methodological quality.…”

A mutation in the viral sensor 2’-5’-oligoadenylate synthetase 2 causes failure of lactation

“…For example, in women the severity of symptoms of mastitis do not correlate with the level of bacterial infection, the disease is often observed in the absence of bacteria in the milk, bacteria are often found in the milk of healthy mothers, and meticulous hygiene or prophylactic antibiotics do not prevent mastitis (reviewed [ 13 ]). Recent Cochrane Systematic Reviews concluded that there is insufficient evidence to support antibiotic use for the prevention [ 14 ] or treatment [ 15 ] of mastitis. The strongest risk factors for mastitis in women involve incomplete or interrupted milk flow from one or more galactophores [ 13 ] and the World Health Organization recognizes milk stasis as the cause of mastitis [ 16 ].…”

Study protocol: evaluation of the probiotic Lactobacillus Fermentum CECT5716 for the prevention of mastitis in breastfeeding women: a randomised controlled trial

“…Although the Cochrane review reported an overall 57% non-significant reduction in mastitis [24], with individual trials finding an up to 76% reduced risk [25], we chose a more conservative 50% reduction as a clinically meaningful treatment effect. Based on an expected rate of mastitis in the control group of 18% [9–11], two-sided 5% significance level and a power of 80%, we estimated a total sample size of 452 would be required.…”

Incidence of and Risk Factors for Lactational Mastitis: A Systematic Review

“…Many of the risk factors mentioned in this review appear amenable to mediation by women’s breastfeeding behavior and practices. A recent Cochrane review of five randomized controlled trials of interventions for preventing mastitis found no significant difference in mastitis incidence between women who received and did not receive the intervention ( Crepinsek et al, 2012 ). These trials included both use of antibiotics, as well as education and use of breastfeeding techniques to reduce the risk of mastitis; however, the reviewed studies were small and of poor methodological quality.…”

A mutation in the viral sensor 2’-5’-oligoadenylate synthetase 2 causes failure of lactation

“…For example, in women the severity of symptoms of mastitis do not correlate with the level of bacterial infection, the disease is often observed in the absence of bacteria in the milk, bacteria are often found in the milk of healthy mothers, and meticulous hygiene or prophylactic antibiotics do not prevent mastitis (reviewed [ 13 ]). Recent Cochrane Systematic Reviews concluded that there is insufficient evidence to support antibiotic use for the prevention [ 14 ] or treatment [ 15 ] of mastitis. The strongest risk factors for mastitis in women involve incomplete or interrupted milk flow from one or more galactophores [ 13 ] and the World Health Organization recognizes milk stasis as the cause of mastitis [ 16 ].…”

Study protocol: evaluation of the probiotic Lactobacillus Fermentum CECT5716 for the prevention of mastitis in breastfeeding women: a randomised controlled trial

“…Although the Cochrane review reported an overall 57% non-significant reduction in mastitis [24], with individual trials finding an up to 76% reduced risk [25], we chose a more conservative 50% reduction as a clinically meaningful treatment effect. Based on an expected rate of mastitis in the control group of 18% [9–11], two-sided 5% significance level and a power of 80%, we estimated a total sample size of 452 would be required.…”