Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Int Breastfeed J. 2022 Mar 28;17(1):24. doi: 10.1186/s13006-022-00464-x.
Lactational mastitis is an extremely painful and distressing inflammation of the breast, which can seriously disrupt breastfeeding. Most of the evidence on the frequency of this condition and its risk factors is from high-income countries. Thus, there is a crucial need for more information on lactational mastitis and its associated factors in Sub-Saharan Africa (SSA).
We used data from representative, community-based cross-sectional household surveys conducted in 2020 with 3,315 women from four countries (Ethiopia, Kenya, Malawi, and Tanzania) who reported ever-breastfeeding their last child born in the two years before the survey. Our measure of lactational mastitis was self-reported and defined using a combination of breast symptoms (breast redness and swelling) and flu-like symptoms (fever and chills) experienced during the breastfeeding period. We first estimated country-specific and pooled prevalence of self-reported lactational mastitis and examined mastitis-related breastfeeding discontinuation. Additionally, we examined factors associated with reporting mastitis in the pooled sample using bivariate and multivariable logistic regression accounting for clustering at the country level and post-stratification weights.
The prevalence of self-reported lactational mastitis ranged from 3.1% in Ethiopia to 12.0% in Kenya. Close to 17.0% of women who experienced mastitis stopped breastfeeding because of mastitis. The adjusted odds of self-reported lactational mastitis were approximately two-fold higher among women who completed at least some primary school compared to women who had no formal education. Study participants who delivered by caesarean section had 1.46 times higher odds of reporting lactational mastitis than women with a vaginal birth. Despite wide confidence intervals, our models also indicate that young women (15 - 24 years) and women who practiced prelacteal feeding had higher odds of experiencing lactational mastitis than older women (25 + years) and women who did not give prelacteal feed to their newborns.
The prevalence of lactational mastitis in four countries of SSA might be somewhat lower than estimates reported from other settings. Further studies should explore the risk and protective factors for lactational mastitis in SSA contexts and address its negative consequences on breastfeeding.
哺乳期乳腺炎是一种极其痛苦和令人痛苦的乳房炎症，会严重扰乱母乳喂养。关于这种疾病的频率及其危险因素的大多数证据来自高收入国家。因此，迫切需要更多关于撒哈拉以南非洲（SSA）哺乳期乳腺炎及其相关因素的信息。
我们使用了来自代表性的、基于社区的横断面家庭调查的数据，该调查于 2020 年在四个国家（埃塞俄比亚、肯尼亚、马拉维和坦桑尼亚）进行，共有 3315 名报告最近两年内曾用母乳喂养其最后一个孩子的妇女参加了调查。我们使用乳房症状（乳房发红和肿胀）和哺乳期出现的流感样症状（发热和寒战）的组合来衡量哺乳期乳腺炎，这些症状是自我报告的。我们首先估计了各国特有的和总体的自我报告的哺乳期乳腺炎患病率，并检查了乳腺炎相关的母乳喂养中断情况。此外，我们使用二变量和多变量逻辑回归，考虑了国家层面的聚类和后分层权重，在汇总样本中检查了与报告乳腺炎相关的因素。
自我报告的哺乳期乳腺炎患病率从埃塞俄比亚的 3.1%到肯尼亚的 12.0%不等。近 17.0%的乳腺炎患者因乳腺炎而停止母乳喂养。与没有正规教育的妇女相比，至少完成一些小学教育的妇女自我报告哺乳期乳腺炎的调整后 odds 大约高出两倍。与阴道分娩的妇女相比，剖宫产分娩的妇女报告哺乳期乳腺炎的 odds 高 1.46 倍。尽管置信区间很宽，但我们的模型还表明，年轻妇女（15-24 岁）和进行初乳喂养的妇女比年龄较大的妇女（25 岁及以上）和不给新生儿初乳的妇女更容易发生哺乳期乳腺炎。
SSA 四个国家的哺乳期乳腺炎患病率可能略低于其他环境报告的估计值。进一步的研究应探讨 SSA 背景下哺乳期乳腺炎的风险和保护因素，并解决其对母乳喂养的负面影响。
