Incidence of Mastitis in the Neonatal Period in a Traditional Breastfeeding Society: Results of a Cohort Study.
BACKGROUND
Mastitis is a painful problem experienced by breastfeeding women, especially in the first few weeks postpartum. There have been limited studies of the incidence of mastitis from traditionally breastfeeding societies in South Asia. This study investigated the incidence, determinants, and management of mastitis in the first month postpartum, as well as its association with breastfeeding outcomes at 4 and 6 months postpartum, in western Nepal.


METHODS
Subjects were a subsample of 338 mothers participating in a larger prospective cohort study conducted in 2014 in western Nepal. Mothers were interviewed during the first month postpartum and again at 4 and 6 months to obtain information on breastfeeding practices. The association of mastitis and determinant variables was investigated using multivariable logistic regression, and the association with breastfeeding duration was examined using Kaplan-Meier estimation.


RESULTS
The incidence of mastitis was 8.0% (95% confidence interval, 5.1%, 10.8%) in the first month postpartum. Prelacteal feeding (adjusted odds ratio = 2.76; 95% confidence interval, 1.03, 7.40) and cesarean section (adjusted odds ratio = 3.52; 95% confidence interval, 1.09, 11.42) were associated with a higher likelihood of mastitis. Kaplan-Meier estimation showed no significant difference in the duration of exclusive breastfeeding among the mothers who experienced an episode of mastitis and those who did not.


CONCLUSIONS
Roughly one in 10 (8.0%) women experienced mastitis in the first month postpartum, and there appeared to be little effect of mastitis on breastfeeding outcomes. Traditional breastfeeding practices should be encouraged, and the management of mastitis should be included as a part of lactation promotion.
School of Public Health, Curtin University , Perth, Western Australia , Australia.
Vishnu
V
Khanal
School of Public Health, Curtin University , Perth, Western Australia , Australia.
Jane A
JA
Scott
School of Public Health, Curtin University , Perth, Western Australia , Australia.
Andy H
AH
Lee
School of Public Health, Curtin University , Perth, Western Australia , Australia.
Colin W
CW
Binns
D000328:Adult; D001942:Breast Feeding / Q000009:adverse effects / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007774:Lactation; D008297:Male; D008413:Mastitis / Q000453:epidemiology* / Q000523:psychology; D009035:Mothers / Q000523:psychology; D009390:Nepal / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors