This is not the most recent version of the article. View current version (17 OCT 2012)

Intervention Review

Interventions for preventing mastitis after childbirth

  1. Maree A Crepinsek1,*,
  2. Linda Crowe2,
  3. Keryl Michener3,
  4. Neil A Smart4

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 4 AUG 2010

Assessed as up-to-date: 2 MAY 2010

DOI: 10.1002/14651858.CD007239.pub2


How to Cite

Crepinsek MA, Crowe L, Michener K, Smart NA. Interventions for preventing mastitis after childbirth. Cochrane Database of Systematic Reviews 2010, Issue 8. Art. No.: CD007239. DOI: 10.1002/14651858.CD007239.pub2.

Author Information

  1. 1

    Gold Coast, Queensland, Australia

  2. 2

    Mater Mother's Research Centre, Neonatal Research Program, South Brisbane, Brisbane, Australia

  3. 3

    University of Queensland Library, Herston Health Sciences Library, Brisbane, QLD, Australia

  4. 4

    Bond University, Faculty of Health Science and Medicine, Robina, Queensland, Australia

*Maree A Crepinsek, PO Box 1098, Pacific Fair, Gold Coast, Queensland, 4218, Australia. mareeanne.crepinsek@scu.edu.au.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 4 AUG 2010

SEARCH

This is not the most recent version of the article. View current version (17 OCT 2012)

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. Resumen
  5. 摘要

Background

Despite the health benefits of breastfeeding, initiation and duration rates continue to fall short of international guidelines. Many factors influence a woman's decision to wean; the main reason cited for weaning is associated with lactation complications, such as mastitis.

Objectives

To assess the effects of preventive strategies for mastitis and the subsequent effect on breastfeeding duration.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (November 2009), CENTRAL (The Cochrane Library 2009, Issue 4), MEDLINE (1950 to November 2009), EMBASE (1974 to November 2009), CINAHL (1981 to November 2009), MIDIRS (1971 to November 2009), IPA (1970 to November 2009), AMED (1985 to November 2009) and LILACS (1982 to November 2009).

Selection criteria

We included randomised controlled trials of interventions for preventing mastitis in postpartum breastfeeding women.

Data collection and analysis

We independently identified relevant studies and assessed the trial quality. We contacted trial authors for missing data and information as appropriate.

Main results

We included five trials (involving 960 women). In three trials of 471 women, we found no significant differences in the incidence of mastitis between use of antibiotics and no antibiotics (risk ratio (RR) 0.43; 95% confidence interval (CI) 0.11 to 1.61; or in one trial of 99 women comparing two doses (RR 0.38; 95% CI 0.02 to 9.18). We found no significant differences for mastitis in three trials of specialist breastfeeding education with usual care (one trial); anti-secretory factor cereal (one trial); and mupirocin, fusidic acid ointment or breastfeeding advice (one trial).

Generally we found no differences in any of the trials for breastfeeding initiation or duration; or symptoms of mastitis.

Authors' conclusions

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.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. Resumen
  5. 摘要

Interventions for the prevention of mastitis following childbirth

Healthcare authorities and the World Health Organization recommend that newborn infants should exclusively be given breast milk until they are six months of age. Breastfeeding provides health benefits for the infant, including improved nutrition and protection against illnesses such as gastroenteritis, respiratory and ear infections, urinary tract infections, allergies and diabetes mellitus. Breastfeeding also saves on costs and has benefits for the mother. Mastitis is a significant complication of lactation and may stop some mothers from breastfeeding. The nipple becomes sore and the breast tender and swollen. If the nipple cracks, the breast can become infected and the mother may experience flu-like symptoms. Poor breast attachment and inadequate emptying of milk from the breast when feeding may contribute to developing mastitis. It is important to investigate preventive measures in order to maintain and increase breastfeeding exclusivity and duration.

This review found five randomised controlled trials that involved a total of 960 women. They looked at a variety of preventive interventions including breastfeeding education, taking antibiotic medication, topical ointments and anti-secretory factor cereal. None of the therapies made any difference in reducing breast infections or the length of breastfeeding exclusivity and duration with this limited evidence. Generally studies were of low quality, with limited findings highlighting the need for better quality research in this area.

 

Resumen

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. Resumen
  5. 摘要

Antecedentes

Intervenciones para la prevención de la mastitis después del parto

A pesar de los beneficios para la salud de la lactancia materna, las tasas de inicio y duración distan mucho de los valores de las guías internacionales. Numerosos factores influyen en la decisión de la madre de interrumpir la lactancia materna; el principal motivo citado del destete se asocia con las complicaciones de la lactancia, como la mastitis.

Objetivos

Evaluar los efectos de las estrategias de prevención de la mastitis y el posterior efecto en la duración de la lactancia materna.

Estrategia de búsqueda

Se hicieron búsquedas en el Registro Especializado de Ensayos Controlados del Grupo Cochrane de Embarazo y Parto (Cochrane Pregnancy and Childbirth Group) (noviembre 2009), CENTRAL (Cochrane Library 2009, número 4), MEDLINE (1950 hasta noviembre 2009), EMBASE (1974 hasta noviembre 2009), CINAHL (1981 hasta noviembre 2009), MIDIRS (1971 hasta noviembre 2009), IPA (1970 hasta noviembre 2009), AMED (1985 hasta noviembre 2009) y en LILACS (1982 hasta noviembre 2009).

Criterios de selección

Se incluyeron los ensayos controlados con asignación aleatoria de intervenciones para la prevención de la mastitis en puérperas en lactancia materna.

Obtención y análisis de los datos

De forma independiente se identificaron estudios relevantes y se evaluó la calidad de los ensayos. Cuando fue necesario, se estableció contacto con los revisores para obtener información y datos que faltaban.

Resultados principales

Se incluyeron cinco ensayos (con 960 mujeres). En tres ensayos con 471 pacientes, no se hallaron diferencias significativas en la incidencia de mastitis entre el uso de antibióticos y sin antibióticos (cociente de riesgos [CR] 0,43, intervalo de confianza [IC] del 95%: 0,11 a 1,61; o en un ensayo con 99 pacientes que comparó dos dosis [CR 0,38; IC del 95%: 0,02 a 9,18]). En tres ensayos de educación en lactancia materna por especialistas no se hallaron diferencias significativas para la mastitis con atención habitual (un ensayo); cereal con factor antisecretor (un ensayo); y mupirocina, ungüento de ácido fusídico o asesoramiento sobre la lactancia materna (un ensayo).

En general no se hallaron diferencias en ninguno de los ensayos en cuanto al inicio ni la duración de la lactancia materna; o síntomas de mastitis.

Conclusiones de los autores

No hubo pruebas suficientes para demostrar la efectividad de ninguna de las intervenciones, incluida la educación en lactancia materna, los tratamientos farmacológicos y las terapias alternativas, con respecto a la incidencia de mastitis o la exclusividad y la duración de la lactancia materna. Si bien los estudios informaron la incidencia de la mastitis, todos ellos emplearon diferentes intervenciones. Hay que tener cautela al analizar los hallazgos de esta revisión, ya que la conclusión se basa en estudios que en general poseían pequeños tamaños de la muestra. Existe una necesidad imperiosa de mayor investigación al respecto y con un adecuado poder estadístico para poder determinar con certeza la efectividad de estas intervenciones.

Traducción

Traducción realizada por el Centro Cochrane Iberoamericano

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. Resumen
  5. 摘要

背景

預防產後乳腺炎

雖然餵母乳有很多好處,實施率和哺乳期間仍低於國際準則.許多因素影響讓婦女停餵母乳,主因為泌乳困難,如乳腺炎

目標

評估預防乳腺炎的療法和對餵乳期間的影響

搜尋策略

搜尋 Cochrane Pregnancy and Childbirth Group's Trials Register (November 2009), CENTRAL (The Cochrane Library 2009, Issue 4), MEDLINE (1950 to November 2009), EMBASE (1974 to November 2009), CINAHL (1981 to November 2009), MIDIRS (1971 to November 2009), IPA (1970November 2009), AMED (1985November 2009) 和 LILACS (1982November 2009).

選擇標準

介入隨機對照試驗,對產後哺乳的女性預防乳腺炎作比較.

資料收集與分析

尋找獨立的相關試驗並評估品質.聯繫作者取得遺漏的資料和適當資訊

主要結論

納入5個試驗 (960人). 其中三個試驗 (471位婦女) 顯示乳腺炎發生率在有沒有使用抗生素的兩組中,沒有差異 (RR0.43; 95% CI0.11−1.61); 一個99名婦女的試驗中比較兩個抗生素劑量,也沒有差異 (RR 0.38; 95% CI 0.02 to 9.18). 三個哺乳教育專家的試驗中,乳腺炎沒有顯著差異,一個試驗採一般照護; 一個試驗採服用抗分泌因子穀物,一個試驗採mupirocin, fusidic acid藥膏或哺乳建議.任何試驗的哺乳率和期間,乳腺炎症狀都沒有差異

作者結論

沒有足夠證據顯示任何介入對乳腺炎發生率,哺乳率和期間,有療效,包含哺乳教育,藥物和替代療法.所有的試驗都採不同介入方式,紀錄乳腺炎發生率.本回顧必需慮的是試驗的樣本數小.未來需更多適當且足夠的研究來確定介入的效果.

翻譯人

本摘要由成功大學附設醫院尹子真翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

預防產後乳腺炎:醫療機構和世衛組織建議新生兒英於六個月前食用母乳.餵母乳對嬰兒的的健康有益,包含營養助益和對腸胃炎,呼吸道'耳及泌尿道感染,過敏和糖尿病等疾病的保護.餵母乳也可節省金錢和對母親有益.乳腺炎是泌乳的主要併發症,會讓母親停止餵母乳.會造成乳頭疼痛發炎,乳房敏感且腫脹.若乳頭破裂,乳房會受感染,母親會有感冒症狀.不良的內衣和餵母乳時排乳不全會引起乳腺炎.應研究預防乳腺炎的方式,以維持和增加餵母乳率和期間.本回顧找到五個隨機對照試驗,960位婦女.研究不同介入包含哺乳衛教,外用乳膏,抗生素服用和食用抗泌乳因子穀物.但對降低乳房感染,泌乳率和哺乳期間都沒有任何差異.試驗品質不佳,限制了突出的發現, 所以在這方面需要品質更好的研究.