• breastfeeding
• breastmilk expression
• exclusive breastmilk expression
• exclusive pumping
• human milk
• infants
• lactation

• Female
• Humans
• Infant, Newborn
• Breast Feeding
• Breast Milk Expression/statistics & numerical data
• Health Knowledge, Attitudes, Practice
• Milk, Human

• Breast infections
• Epidemiology
• Methicillin-resistant Staphylococcus aureus
• USA300

Although lactation mastitis (LM) has been extensively researched, the incidence rate of LM remains a salient clinical problem. To reduce this incidence rate and achieve a better prognosis, early and specific quantitative indicators are particularly important. It has been found that milk electrolyte concentrations (chloride, potassium, and sodium) and electrical conductivity (EC) significantly change in the early stages of LM in an animal model. Several studies have evaluated EC for the detection of subclinical mastitis in cows. EC, chloride, and sodium content of milk were more accurate for predicting infection status than were other variables. In the early stages of LM, lactic sodium, chloride, and EC increase, but potassium decreases. However, these indicators have not been reported in the diagnosis of LM in humans. This review summarizes the pathogenesis and the mechanism of LM in terms of milk electrolyte concentration and EC, and aim to provide new ideas for the detection of sub-clinical mastitis in humans.

• Lactation mastitis
• Milk electrolyte concentration
• Milk electrical conductivity
• Pathogenesis
• Mechanism
• Early diagnosis

• breast abscess
• breastfeeding
• needle aspiration
• surgery

• Abscess/diagnostic imaging
• Abscess/etiology
• Abscess/therapy
• Anti-Bacterial Agents/therapeutic use
• Breast Diseases/diagnostic imaging
• Breast Diseases/etiology
• Breast Diseases/therapy
• Breast Feeding/adverse effects
• Female
• Humans
• Mastitis/drug therapy
• Mastitis/etiology
• Pregnancy
• Retrospective Studies
• Staphylococcus aureus

Group B Streptococcus (GBS) is a major cause of serious neonatal infection but its role in maternal morbidity has received little investigation. The aim of this study was to determine whether GBS colonization at delivery is associated with increased risk of maternal peripartum infection.

In this prospective cohort study, 1746 unselected women had a vaginal-rectal culture taken at the onset of labor. Diagnosis of maternal peripartum infection was based on a combination of two or more signs or symptoms including fever, breast pain, severe wound or pelvic pain, purulent discharge and abnormal laboratory tests including C-reactive protein and white blood cell count occurring from labor until 2 weeks postpartum. The main outcome measure was the proportion of women with maternal peripartum infection according to GBS colonization status.

A total of 25.9% (452/1746) women were colonized with GBS. The rate of peripartum infection was almost twice as high in colonized women (49/452 [10.8%]) vs. non-colonized women (81/1294 [6.3%]); OR 1.82 [1.26–2.64], p = 0.002). This association was confirmed in a multivariable model (OR 1.99 [1.35–2.95], p = 0.001). Women diagnosed with peripartum infection had a significantly longer hospital stay compared to women without peripartum infection (4 days (median) vs. 3 days, p < 0.001). Length of hospital stay did not differ between colonized and non-colonized women. Serotype IV GBS was more frequent in colonized women with peripartum infection than in women without peripartum infection (29.3% vs. 12.5%, p = 0.003).

GBS colonization at delivery is associated with increased risk of peripartum infection. Whether this increase is due directly to invasion by GBS or whether GBS colonization is associated with a more general vulnerability to infection remains to be determined.

• Female
• Humans
• Infant, Newborn
• Peripartum Period
• Pregnancy
• Pregnancy Complications, Infectious/epidemiology
• Prospective Studies
• Rectum
• Streptococcal Infections/epidemiology
• Streptococcus agalactiae
• Vagina

• The Norwegian SIDS and Stillbirth Society
• The Eckbo Foundation
• Renée and Bredo Grimsgaard Foundation

• breast abscess
• breastfeeding
• lactation
• mastitis

Objective: To identify the potential risk factors for acute mastitis during lactation comprehensively. Subsequently, to evaluate logistic regression model in predicting the risk of lactational mastitis in Chinese women by applying receiver operating characteristic (ROC) curve.

Methods: A case–control study among Chinese women enrolled 652 patients with mastitis and 581 healthy women with breastfeeding experience as control. The retrospective information was obtained by questionnaires that included medical history of pregnancy, delivery, puerperium and breastfeeding behaviors. Univariate analysis and multivariate logistic regression model were performed to investigate the relationship between these factors and the occurrence of lactational mastitis. Using ROC curve to evaluate the prognostic value of these selected indicators in the risk of acute mastitis.

Results: The multivariate logistic regression analysis showed that the primiparity (P < 0.001), mastitis in previous breastfeeding (P < 0.001), nipple’s heteroplasia (P < 0.001), cracked nipple (P < 0.001), breast trauma by external force (P = 0.002), lateral position (P = 0.007), breast pump (P = 0.039), nipple sucking (P = 0.007), sleep with sucking (P = 0.007), and tongue-tie (P = 0.013) were risk variables independently and significantly related with mastitis. While vaginal delivery (P = 0.015), clean nipple before breastfeeding (P = 0.015), first contact with child within 1 h (P = 0.027) were protective factors. The ROC analysis demonstrated that the area under the curve of model 2 was 0.8122 (95%CI = 0.7885–0.8360), which stated that the model presented a high sensitivity and specificity.

Conclusion: By means of collecting and summarizing the risk factors associated with the occurrence of breast mastitis in Chinese women, we established risk discriminant model to identify and warn the individuals susceptible to acute mastitis early, which will allow practitioners to provide appropriate management advice and effective individual care.

• Breastfeeding
• Logistic Regression
• Mastitis
• ROC curve
• Risk factors

• Adult
• Child
• Female
• Humans
• Manipulation, Orthopedic
• Manipulation, Osteopathic
• Mastitis/therapy
• Osteopathic Medicine
• Osteopathic Physicians

Les abcès du sein sont des collections purulentes néoformées au niveau de la glande mammaire et du tissu péri glandulaire. Ils peuvent être lactants ou non lactants. L’objectif de notre étude était de décrire leurs caractéristiques épidémiologiques, diagnostiques et thérapeutiques au Service de Chirurgie Générale de l’Hôpital Principal de Dakar. Nous avions réalisé une étude rétrospective, descriptive sur une période de 4 ans portant sur tous les patients pris en charge pour un abcès du sein. Nous avions colligé 41 dossiers de patients tous de sexe féminin. L’âge moyen était de 31 ans. Le principal facteur de risque objectivé était la mastite au cours de l’allaitement (27%). Le délai moyen d’évolution était de 12 jours avec des extrêmes de 1 et 30 jours. L’abcès siégeait à gauche dans 61% des cas et se présentait le plus souvent sous la forme d’une tuméfaction inflammatoire (88%). Les quadrants supérieurs étaient le plus souvent concernés (43,9%). L’échographie mammaire était réalisée chez 51,2% des patientes. Le drainage chirurgical sous anesthésie générale était réalisé chez toutes les patientes. La quantité moyenne de pus était de 119 cc. Le germe le plus fréquemment isolé était le Staphylococcus aureus (79,5%). La durée moyenne d’hospitalisation était de 7 jours et la morbidité opératoire de 31,7%. La mortalité était nulle. La prévention des abcès lactants passe par l’enseignement des méthodes d’allaitement et l’antibiothérapie précoce en cas de mastite.

• Breast abscess
• Dakar
• diagnostic
• epidemiological features
• therapeutic

• Breast abscess
• Breastfeeding
• Granulomatous mastitis
• Mastitis
• Pregnancy

Lactational breast abscesses are uncommon in the puerperium but when they do develop, delays in specialist referral may occur especially in resource low settings. There is a dearth of studies regarding lactational breast abscesses in Cameroon. We aimed to estimate the incidence of lactational breast abscess and describe its management by percutaneous aspiration at the Douala General Hospital, Cameroon.

We conducted an observational prospective study of 25 breastfeeding women at the Douala General Hospital from January 1, 2015, to October 31, 2015. Participants were consenting breastfeeding women who completed a baseline questionnaire after diagnosis of lactational breast abscesses and underwent percutaneous needle aspiration under local anaesthesia. Data were analyzed by using descriptive statistics.

The estimated incidence of lactational breast abscesses was 0.74% (28/3792). The age range of babies at the onset of breast abscess was 4 to 35 weeks; mean 28.3 ± 10.85 weeks. Forty-four per cent of participants underwent three lactational abscess aspirations and in 24 to 28% of them, it took 8 to 9 days for the abscess to resolve. In 72% of participants, treatment was with needle aspiration plus flucloxacillin. Seventy-six per cent of participants continued breastfeeding after abscess treatment.

The estimated incidence of lactational breast abscess at the Douala General Hospital is 0.74%. Percutaneous needle aspiration under local anaesthesia is an effective treatment for superficial lactational breast abscesses in most cases with or without ultrasound guidance and should be recommended worldwide as first line treatment. Further research is needed to understand the outcome of local infiltration of antibiotics on the abscess cavity.

• Abscess
• And mastitis
• Breast
• Breastfeeding
• Drainage
• Lactation

• Mastitis
• abscess
• infection
• lactation

• breast pain
• breastfeeding
• breastfeeding difficulties
• human milk collection
• mastitis
• weaning

• Abscess/etiology
• Abscess/therapy
• Adult
• Biopsy, Fine-Needle/methods
• Breast Diseases/etiology
• Breast Diseases/therapy
• Breast Feeding
• Cephalosporins/therapeutic use
• Drainage/methods
• Female
• Humans
• Mastitis/etiology
• Mastitis/therapy
• Randomized Controlled Trials as Topic
• Treatment Failure
• Ultrasonography, Interventional

• Staphylococcus aureus
• Sortase A
• inflammatory response
• mastitis
• mitogen-activated protein kinases
• nuclear factor-κB

To determine the health and economic burdens of post-partum Staphylococcus aureus breast abscess.

We conducted a matched cohort study (N = 216) in a population of pregnant women (N = 32,770) who delivered at our center during the study period from 10/1/03–9/30/10. Data were extracted from hospital databases, or via chart review if unavailable electronically. We compared cases of S. aureus breast abscess to controls matched by delivery date to compare health services utilization and mean attributable medical costs in 2012 United States dollars using Medicare and hospital-based estimates. We also evaluated whether resource utilization and health care costs differed between cases with methicillin-resistant and -susceptible S. aureus isolates.

Fifty-four cases of culture-confirmed post-partum S. aureus breast abscess were identified. Breastfeeding cessation (41%), milk fistula (11.1%) and hospital readmission (50%) occurred frequently among case patients. Breast abscess case patients had high rates of health services utilization compared to controls, including high rates of imaging and drainage procedures. The mean attributable cost of post-partum S. aureus breast abscess ranged from $2,340–$4,012, depending on the methods and data sources used. Mean attributable costs were not significantly higher among methicillin-resistant vs. –susceptible S. aureus cases.

Post-partum S. aureus breast abscess is associated with worse health and economic outcomes for women and their infants, including high rates of breastfeeding cessation. Future study is needed to determine the optimal treatment and prevention of these infections.

• Abscess/economics
• Abscess/epidemiology
• Abscess/microbiology
• Case-Control Studies
• Cohort Studies
• Cost of Illness
• Female
• Health Care Costs
• Health Services/economics
• Humans
• Mastitis/economics
• Mastitis/epidemiology
• Mastitis/microbiology
• Outcome Assessment, Health Care
• Postpartum Period
• Pregnancy
• Staphylococcal Infections/economics
• Staphylococcal Infections/epidemiology
• Staphylococcus aureus

• UL1 RR025758 NCRR NIH HHS
• UL1 RR 025758 NCRR NIH HHS

• Adult
• Age Factors
• Causality
• Comorbidity
• Cross Infection/epidemiology
• Diabetes Mellitus, Type 2/epidemiology
• Diabetes, Gestational/epidemiology
• Female
• Hospitals, Community/statistics & numerical data
• Humans
• Methicillin-Resistant Staphylococcus aureus/pathogenicity
• Pregnancy
• Prevalence
• Puerperal Disorders/epidemiology
• Risk Factors
• Socioeconomic Factors
• Staphylococcal Infections/epidemiology
• United States/epidemiology