Bejegyzés

Caring for new mothers: diagnosis, management and treatment of nipple dermatitis in breastfeeding mothers.

Heller MM, Fullerton-Stone H, Murase JE.
Int J Dermatol. 2012 Oct;51(10):1149-61.

Abstract

Breastfeeding is thought to be the most optimal form of infant nutrition. Nursing mothers are generally advised to continue breastfeeding until the infant is two years of age or beyond. Unfortunately, however, a majority of nursing mothers will discontinue breastfeeding much earlier than recommended. The most common reason for early discontinuation of breastfeeding is nipple pain. It is, therefore, essential that dermatologists know how to appropriately diagnose and effectively treat nipple pain associated with nipple dermatitis among nursing mothers. This review article provides a detailed discussion on the clinical features and management of various causes of nipple dermatitis during lactation, including problems with infant latch-on, congenital oral anomalies, plugged lactiferous ducts, atopic dermatitis, irritant contact dermatitis, allergic contact dermatitis, yeast infections, bacterial infections, herpes simplex virus, and Raynaud’s phenomenon of the nipple.
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Factors predicting early discontinuation of exclusive breastfeeding in the first month of life

Vieira GO, Martins CC, Vieira TO, de Oliveira NF, Silva LR.
J Pediatr (Rio J). 2010 Sep-Oct;86(5):441-4.

Abstract

OBJECTIVE: To investigate factors associated with discontinuation of exclusive breastfeeding in the first month of lactation, in the city of Feira de Santana, Brazil.

METHODS: Cohort study with follow-up of 1,309 mother-child pairs selected from all maternities in the municipality. Data were collected in hospital and in home visits during the first month of life. Logistic regression analysis was used to examine the relationship between outcome and variables of interest.

RESULTS: Lack of prior breastfeeding experience (PR 1.24; 95%CI 1.75-1.43), cracked nipples (PR 1.25; 95%CI 1.09-1.43), use of fixed breastfeeding schedules (PR 1.42; 95%CI 1.09-1.84) and pacifier use (PR 1.53; 95%CI 1.34-1.76) were identified as factors predicting discontinuation of exclusive breastfeeding.
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The Absence of Candida albicans in Milk Samples of Women with Clinical Symptoms of Ductal Candidiasis

Thomas W. Hale, Tiffany L. Bateman, Malcolm A. Finkelman and Pamela D. Berens
BREASTFEEDING MEDICINE Volume 4, Number 2, 2009

Abstract

Objective: The objective of this prospective study was to determine if Candida albicans is present in the milk of women suffering from symptoms of severe nipple and deep breast pain.

Study Design: The symptomatic group included women who reported sore, inflamed, or traumatized nipples or intense stabbing or burning pain. The control group included breastfeeding women without symptoms. The skin of the nipple and areola were washed with detergent and thoroughly rinsed. Milk samples were analyzed for (1 → 3)-β-D-glucan and grown on Candida growth medium.
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Management of Mastitis in Breastfeeding Women

JEANNE P. SPENCER
Am Fam Physician. 2008 Sep 15;78(6):727-731.

Abstract

Mastitis occurs in approximately 10 percent of U.S. mothers who are breastfeeding, and it can lead to the cessation of breastfeeding. The risk of mastitis can be reduced by frequent, complete emptying of the breast and by optimizing breastfeeding technique. Sore nipples can precipitate mastitis. The differential diagnosis of sore nipples includes mechanical irritation from a poor latch or infant mouth anomalies, such as cleft palate or bacterial or yeast infection. The diagnosis of mastitis is usually clinical, with patients presenting with focal tenderness in one breast accompanied by fever and malaise.
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Oral Administration of Lactobacillus Strains Isolated from Breast Milk as an Alternative for the Treatment of Infectious Mastitis during Lactation

E. Jiménez, L. Fernández, A. Maldonado, R. Martín, M. Olivares, J. Xaus and J. M. Rodríguez

Applied and Environmental Microbiology, August 2008, p. 4650-4655, Vol. 74, No. 15

Abstract

In this study, 20 women with staphylococcal mastitis were randomly divided in two groups. Those in the probiotic group daily ingested 10 log10 CFU of Lactobacillus salivarius CECT5713 and the same quantity of Lactobacillus gasseri CECT5714 for 4 weeks, while those in the control one only ingested the excipient. Both lactobacillus strains were originally isolated from breast milk. On day 0, the mean staphylococcal counts in the probiotic and control groups were similar (4.74 and 4.81 log10 CFU/ml, respectively), but lactobacilli could not be detected.
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The role of bacteria in lactational mastitis and some considerations of the use of antibiotic treatment.

Kvist LJ, Larsson BW, Hall-Lord ML, Steen A, Schalén C.
Int Breastfeed J. 2008 Apr 7;3:6.

Abstract

BACKGROUND: The role of bacterial pathogens in lactational mastitis remains unclear. The objective of this study was to compare bacterial species in breast milk of women with mastitis and of healthy breast milk donors and to evaluate the use of antibiotic therapy, the symptoms of mastitis, number of health care contacts, occurrence of breast abscess, damaged nipples and recurrent symptoms in relation to bacterial counts.

METHODS: In this descriptive study, breast milk from 192 women with mastitis (referred to as cases) and 466 breast milk donors (referred to as controls) was examined bacteriologically and compared using analytical statistics.
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An Update on the Recognition and Management of Lactational Breast Inflammation

From Journal of Midwifery & Women’s Health

Christine M. Betzold, NP, CLC, MSN

Abstract

Inflammation of the breast (mastitis) with or without infection or redness has a variety of etiologies and presentations that range from the fairly benign blocked duct to the more serious breast abscess. True infectious mastitis can present in a manner that is easily identifiable, or it can present in a subtle and ambiguous fashion. Some women are challenged with recurrent mastitis, and often the underlying etiology is never discovered.

This review will assist the clinician in recognizing, efficiently diagnosing, and effectively treating breast inflammation caused by infectious and noninfectious processes, including recurrent mastitis.
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Radiologic Evaluation of Breast Disorders Related to Pregnancy and Lactation

Sabate JM, Clotet M, Torrubia S, Gomez A, Guerrero R, de las Heras P, Lerma E.
Radiographics. 2007 Oct;27 Suppl 1:S101-24.

Abstract

During pregnancy and lactation, the breast can be affected by a variety of specific and unique disorders, including benign disorders closely related to physiologic changes, inflammatory and infectious diseases, juvenile papillomatosis, and benign and malignant tumors. Patients with pregnancy-associated breast carcinoma tend to have more advanced neoplasms at diagnosis and a poorer prognosis due to delayed diagnosis and a more aggressive biologic pattern.

Pregnancy-related Burkitt lymphoma characteristically manifests with bilateral and diffuse involvement of the breasts. Fibroadenoma may manifest with growth, infarction, large cysts, prominent ducts, and secretory hyperplasia during pregnancy and lactation.
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Ankyloglossia in Breastfeeding Infants: The Effect of Frenotomy on Maternal Nipple Pain and Latch

Anjana Srinivasan, Carole Dobrich, Howard Mitnick, Perle Feldman
Breastfeeding Medicine. 2006, 1(4): 216-224.

Abstract

Objective: The aim of this study was to measure the effectiveness of frenotomy in ankyloglossic infants, by quantifying the changes in latch and maternal nipple pain using standardized tools.

Methodology: Infants below 12 weeks of age were recruited from the Goldfarb Breastfeeding Program between August 2004 and February 2005. Infants were selected based on the Frenotomy Decision Rule for Breastfeeding Infants (FDRBI), a new clinical tool for future validation. Latch was assessed using the Latch Tool. Maternal nipple pain was assessed using R. Melzack’s Short Form McGill Pain Questionnaire, consisting of the Pain Rating Index (PRI) and Present Pain Intensity (PPI).
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Severity of Mastitis Symptoms as a Predictor of C-Reactive Protein in Milk and Blood During Lactation

Catherine M. Fetherston, Jim I. Wells, Peter E. Hartmann
Breastfeeding Medicine. 2006, 1(3): 127-135.

Abstract

Objective: To investigate the presence of C-reactive protein (CRP) in breast milk and any relationship between changes in CRP in breast milk and blood, and the severity of systemic and breast symptoms experienced during mastitis.

Methods: Mothers (n = 26) were followed prospectively from day 5 postpartum to the end of their lactation. Milk from each breast, blood, 24-hour urine samples and data on breast and systemic pathologies were collected at reference intervals during the first 3 months postpartum, daily during the occurrence of any breast inflammation and at 7 days after resolution of symptoms.
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