چکیده (انگلیسی):

Background:Mastitis is an acute, debilitating condition that occurs in approximately 20 % of breastfeeding women
who experience a red, painful breast with fever. This paper describes the factors correlated with mastitis and investigates
thepresenceof Staphylococcus aureusin women who participated in the CASTLE (Candida and Staphylococcus
Transmission: Longitudinal Evaluation) study. The CASTLE study was a prospective cohort study which recruited
nulliparous women in late pregnancy in two maternity hospitals in Melbourne, Australia in 2009–2011.
Methods:Women completed questionnaires at recruitment and six time-points in the first eight weeks postpartum.
Postpartum questionnaires asked about incidences of mastitis, nipple damage, milk supply, expressing practices and
breastfeeding problems. Nasal and nipple swabs were collected from mothers and babies, as well as breast milk
samples. All samples were cultured forS. aureus. “Time at risk” of mastitis was defined as days between birth and
first occurrence of mastitis (for women who developed mastitis) and days between birth and the last study time-point
(for women who did not develop mastitis). Risk factors for incidence of mastitis occurring during the time at risk
(IncidentRateRatios[IRR])wereinvestigatedusingadiscreteversionofthemultivariableproportionalhazards
regression model.
Results:Twenty percent (70/346) of participants developed mastitis. Women had an increased risk of developing
mastitis if they reported nipple damage (IRR 2.17, 95 % CI 1.21, 3.91), over-supply of breast milk (IRR 2.60, 95 % CI
1.58, 4.29), nipple shield use (IRR 2.93, 95 % CI 1.72, 5.01) or expressing several times a day (IRR 1.64, 95 % CI 1.01, 2.68).
The presence ofS. aureuson the nipple (IRR 1.72, 95 % CI 1.04, 2.85) or in milk (IRR 1.78, 95 % CI 1.08, 2.92) also increased
the risk of developing mastitis.
Conclusions:Nipple damage, over-supply of breast milk, use of nipple shields and the presence ofS. aureuson the
nipple or in breast milk increased the mastitis risk in our prospective cohort study sample. Reducing nipple damage
may help reduce maternal breast infections.