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Determinants of mastitis in women in the CASTLE study: a cohort study

Cullinane, Meabh, Amir, Lisa H., Donath,Susan M., Garland, Suzanne M., Tabrizi, Sepehr N., Payne, Matthew S. and Bennett, Catherine M. 2015, Determinants of mastitis in women in the CASTLE study: a cohort study, BMC family practice, vol. 16, Article Number : 181, pp. 1-8, doi: 10.1186/s12875-015-0396-5.

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Title Determinants of mastitis in women in the CASTLE study: a cohort study
Author(s) Cullinane, Meabh
Amir, Lisa H.
Donath,Susan M.
Garland, Suzanne M.
Tabrizi, Sepehr N.
Payne, Matthew S.
Bennett, Catherine M.ORCID iD for Bennett, Catherine M. orcid.org/0000-0001-9581-1612
Journal name BMC family practice
Volume number 16
Season Article Number : 181
Start page 1
End page 8
Total pages 8
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2015
ISSN 1471-2296
Keyword(s) Breastfeeding
Mastitis
Breast infection
Staphylococcus aureus
Summary 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 the presence of Staphylococcus aureus in 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 for S. 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 (Incident Rate Ratios [IRR]) were investigated using a discrete version of the multivariable proportional hazards 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 of S. aureus on 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 of S. aureus on 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.
Language eng
DOI 10.1186/s12875-015-0396-5
Field of Research 1117 Public Health And Health Services
Socio Economic Objective 920507 Women's Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, The Authors
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080455

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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.