Relationships Between Symptoms and Changes in Breast Physiology During Lactation Mastitis

Abstract

Objective:The objective was to investigate changes in milk composition that reflect variations in breast permeability, milk synthesis, and immune response in women before, during, and after mastitis Methods: Mothers (n ‫؍‬ 26) were followed prospectively from day 5 postpartum to the end of their lactation. Milk from each breast, blood, 24-hour urine samples, and data on breast and systemic pathologies were collected at reference intervals during the first 3 months postpartum, daily during the occurrence of any breast inflammation, and 7 days after resolution of symptoms, and was analyzed using mixed-model analysis (repeated measures).Results: There was a significant difference in sodium (p Ͻ 0.001), chloride (p Ͻ 0.001), serum albumin (p Ͻ 0.02) and lactose (p Ͻ 0.003) in the breast with mastitis when compared with both the contralateral asymptomatic breast and "healthy" breasts. Inflammation of the whole breast was a significant predictor for a decreased glucose (p Ͻ 0.01) and hyperacute systemic symptoms predicted a decrease in milk glucose (p Ͻ 0.03) and an increased lactoferrin (p Ͻ 0.05) and sIgA (p Ͻ 0.03).Conclusions: There is an increased breast permeability, reduced milk synthesis, and increased concentration of the immune components sIgA and lactoferrin with increasing severity of breast and systemic symptoms. The changes observed in milk composition during periods of increased breast permeability cannot be solely explained by the current theory of permeability of the paracellular pathway and further research in this area is required.

Taste of Milk from Inflamed Breasts of Breastfeeding Mothers with Mastitis Evaluated Using a Taste Sensor

“…29 Loss of lactose is one major change that reportedly occurs in the composition of milk during mastitis. 7,10,11 However, we only detected a trend for a decline in the lactose content of milk from inflamed breasts. A decline in lactose synthesis will result in a lower volume of milk rather than a lower concentration of lactose in the milk.…”

“…A decline in lactose synthesis will result in a lower volume of milk rather than a lower concentration of lactose in the milk. Furthermore, a relatively wide interindividual distribution and a small reduction rate in lactose ( < 10% of total content) due to mastitis 10,11 might mask a significant difference. Increases in the factors that cause umami (glutamate and 5¢-GMP) or sodium content were probably associated with an increase in umami or saltiness of milk from inflamed breasts, respectively.…”

“…Mastitis alters the biochemical composition of milk because of increased breast permeability 6,7 and reduced milk synthesis. 7 Increased sodium and chloride [7][8][9][10][11] and decreased lactose 7,10,11 concentrations are specific changes in milk composition that occur during mastitis. Thus, milk might become saltier during mastitis as a result of increased sodium content.…”

Urinary metabolomic fingerprinting after consumption of a probiotic strain in women with mastitis

“…Moreover, its excretion in urine in pregnancy and lactation periods is well documented [27]. Excretion of lactose in urine is a measure of increased permeability of the lactating breast during inflammation [28]. Likewise, Fetherston et al [28], in an attempt to identify possible predictors of mastitis in lactating mothers in the first three months post-partum, observed a significant elevation in the concentration of lactose in urine over a 24-hour period, with the highest levels observed when breast inflammation symptoms were more severe.…”

“…Excretion of lactose in urine is a measure of increased permeability of the lactating breast during inflammation [28]. Likewise, Fetherston et al [28], in an attempt to identify possible predictors of mastitis in lactating mothers in the first three months post-partum, observed a significant elevation in the concentration of lactose in urine over a 24-hour period, with the highest levels observed when breast inflammation symptoms were more severe. These observations led to the conclusion that urinary excretion of lactose could be used as a reliable indicator of mastitis and a predictor of the degree and types of symptom experienced by mothers during this condition.…”