Khanal Vishnu, Scott Jane A, Lee Andy H, Binns Colin W
School of Public Health, Curtin University , Perth, Western Australia , Australia.
Breastfeed Med. 2015 Dec;10(10):481-7. doi: 10.1089/bfm.2015.0080. Epub 2015 Oct 21.
Mastitis is a painful problem experienced by breastfeeding women, especially in the first few weeks postpartum. There have been limited studies of the incidence of mastitis from traditionally breastfeeding societies in South Asia. This study investigated the incidence, determinants, and management of mastitis in the first month postpartum, as well as its association with breastfeeding outcomes at 4 and 6 months postpartum, in western Nepal.
Subjects were a subsample of 338 mothers participating in a larger prospective cohort study conducted in 2014 in western Nepal. Mothers were interviewed during the first month postpartum and again at 4 and 6 months to obtain information on breastfeeding practices. The association of mastitis and determinant variables was investigated using multivariable logistic regression, and the association with breastfeeding duration was examined using Kaplan-Meier estimation.
The incidence of mastitis was 8.0% (95% confidence interval, 5.1%, 10.8%) in the first month postpartum. Prelacteal feeding (adjusted odds ratio = 2.76; 95% confidence interval, 1.03, 7.40) and cesarean section (adjusted odds ratio = 3.52; 95% confidence interval, 1.09, 11.42) were associated with a higher likelihood of mastitis. Kaplan-Meier estimation showed no significant difference in the duration of exclusive breastfeeding among the mothers who experienced an episode of mastitis and those who did not.
Roughly one in 10 (8.0%) women experienced mastitis in the first month postpartum, and there appeared to be little effect of mastitis on breastfeeding outcomes. Traditional breastfeeding practices should be encouraged, and the management of mastitis should be included as a part of lactation promotion.
乳腺炎是哺乳期女性面临的一个痛苦问题，尤其是在产后最初几周。关于南亚传统母乳喂养社会中乳腺炎发病率的研究有限。本研究调查了尼泊尔西部产后第一个月乳腺炎的发病率、决定因素及管理情况，以及其与产后4个月和6个月母乳喂养结局的关联。
研究对象是2014年在尼泊尔西部进行的一项大型前瞻性队列研究中338名母亲的子样本。在产后第一个月以及4个月和6个月时对母亲进行访谈，以获取母乳喂养情况的信息。使用多变量逻辑回归研究乳腺炎与决定因素变量之间的关联，并使用Kaplan-Meier估计法检查与母乳喂养持续时间的关联。
产后第一个月乳腺炎的发病率为8.0%（95%置信区间为5.1%，10.8%）。产前喂养（调整后的优势比=2.76；95%置信区间为1.03，7.40）和剖宫产（调整后的优势比=3.52；95%置信区间为1.09，11.42）与患乳腺炎的可能性较高相关。Kaplan-Meier估计显示，经历过一次乳腺炎发作的母亲与未经历过的母亲在纯母乳喂养持续时间上没有显著差异。
大约十分之一（8.0%）的女性在产后第一个月经历了乳腺炎，且乳腺炎似乎对母乳喂养结局影响不大。应鼓励传统的母乳喂养做法，并将乳腺炎的管理纳入泌乳促进的一部分。
