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Does Candida and/or Staphylococcus play a role in nipple and breast pain in lactation? A cohort study in Melbourne, Australia

Amir, Lisa H., Donath, Susan M., Garland, Suzanne M., Tabrizi, Sepehr N., Bennett, Catherine M., Cullinane, Meabh and Payne, Matthew S. 2013, Does Candida and/or Staphylococcus play a role in nipple and breast pain in lactation? A cohort study in Melbourne, Australia, BMJ open, vol. 3, no. 3, pp. 1-8, doi: 10.1136/bmjopen-2012-002351.

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Title Does Candida and/or Staphylococcus play a role in nipple and breast pain in lactation? A cohort study in Melbourne, Australia
Author(s) Amir, Lisa H.
Donath, Susan M.
Garland, Suzanne M.
Tabrizi, Sepehr N.
Bennett, Catherine M.ORCID iD for Bennett, Catherine M. orcid.org/0000-0001-9581-1612
Cullinane, Meabh
Payne, Matthew S.
Journal name BMJ open
Volume number 3
Issue number 3
Start page 1
End page 8
Total pages 8
Publisher BMJ Publishing Group
Place of publication London, Eng.
Publication date 2013-03-09
ISSN 2044-6055
Summary Objective: To investigate Candida species and Staphylococcus aureus and the development of 'nipple and breast thrush' among breastfeeding women. Design: Prospective longitudinal cohort study. Setting: Two hospitals in Melbourne, Australia (one public, one private) with follow-up in the community. Participants: 360 nulliparous women recruited at 36 weeks' gestation from November 2009 to June 2011. Participants were followed up six times: in hospital, at home weekly until 4 weeks postpartum and by telephone at 8 weeks. Main outcome measures: Case definition 'nipple and breast thrush': burning nipple pain and breast pain (not related to mastitis); detection of Candida spp (using culture and PCR) in the mother's vagina, nipple or breast milk or in the baby's mouth; detection of S aureus in the mother' nipple or breast milk. Results: Women with the case definition of nipple/ breast thrush were more likely to have Candida spp in nipple/breast milk/baby oral samples (54%) compared to other women (36%, p=0.014). S aureus was common in nipple/breast milk/baby samples of women with these symptoms as well as women without these symptoms (82% vs 79%) (p=0.597). Time-to-event analysis examined predictors of nipple/breast thrush up to and including the time of data collection. Candida in nipple/breast milk/baby predicted incidence of the case definition (rate ratio (RR) 1.87 (95% CI 1.10 to 3.16, p=0.018). We do not have evidence that S aureus colonisation was a predictor of these symptoms (RR 1.53, 95% CI 0.88 to 2.64, p=0.13). Nipple damage was also a predictor of these symptoms, RR 2.30 (95% CI 1.19 to 4.43, p=0.012). In the multivariate model, with all three predictors, the RRs were very similar to the univariate RRs. This indicates that Candida and nipple damage are independent predictors of our case definition.
Language eng
DOI 10.1136/bmjopen-2012-002351
Field of Research 110303 Clinical Microbiology
110309 Infectious Diseases
Socio Economic Objective 920109 Infectious Diseases
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2013, BMJ Publishing Group
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30061198

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Created: Wed, 05 Mar 2014, 13:57:58 EST by Catherine Bennett

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.