JOURNAL READING

INCIDENCE OF MASTITIS IN THE NEONATAL PERIOD IN A

TRADITIONAL BREASTFEEDING SOCIETY:
RESULTS OF A COHORT STUDY
Pembimbing :
Dr. dr. Bambang Arianto, Sp.B

Fahrika Luthfi Afiqoh / 201810401011002

Farrel Ryandhika Radityatama / 201704200245
INTRODUCTION
Maternal problems during breastfeeding commonly have been reported to be one of the
reasons for early discontinuation of breastfeeding

Mastitis is a major problem experienced by breastfeeding women, especially in

the first few weeks postpartum (incidence 20%  developed countries)

Several studies have reported that the incidence is highest in the first few
weeks postpartum

The most convincing and acceptable disease process is insufficient removal of

breastmilk leading to milk stasis  abscess and sepsis

Very few published data are available from developing countries. Lactation
problems experienced by Nepalese mothers have not been reported previously
Subject and Methods
1. A prospective cohort study was conducted in the Rupandehi District of
western Nepal during January–October 2014.

2. 735 mothers (378 rural and 357 urban)

3. (inclusion) Mothers who were local residents, had living infants, were within
1 month postpartum, and had a singleton child were recruited into the study.
(exclusion) Mothers were excluded if they were seriously ill or if they were not
a local resident of the selected communities. Participants were followed up
during the fourth (90–120 days) and sixth (150–180 days) months postpartum.

4. The questionnaires were translated into the Nepali language and pretested
before being used in the field.
Subject and Methods
Variable

The response variable used in this study was the incidence of mastitis in
the neonatal period, which was based on selfreported signs and symptoms

Independent variables included in the study were:

1. maternal age
2. maternal education
3. place of delivery
4. prelacteal feeding
5. time of initiation of breastfeeding
6. mode of delivery
7. birth weight (low birth weight [<2500 and] and average or greater
[>2,500 g]).
Subject and Methods
Methods

Factors associated with mastitis were screened using the chi-squared test,
and those factors significantly associated with the incidence of mastitis
were further investigated using multivariable logistic regression.

The association between mastitis and exclusive and predominant

breastfeeding at 4 and 6 months was determined using multivariable
logistic regression adjusting for other independent variables

Statistical analyses were performed using Stata release 14 software and

Statistical Package for Social Sciences version 20 software
RESULT
RESULT
RESULT
RESULT
DISCUSSION
1. We found that 8.0% of mothers reported having an episode
of mastitis within the first 30 days postpartum in western
Nepal.

2. Comparison
First, the reporting periods may differ among the cohort studies,
which might explain some of the variations in the reported
incidence.

Second, we adapted the definition used by Amir et al, of at least

two breast symptoms (pain, redness, or lump) and at least one
of the ‘‘flu-like symptoms’’ (fever, shivering/chills, or headache)
DISCUSSION
3. There was no significant difference in the duration of
exclusive breastfeeding between mothers who did and did
not experience mastitis, which is an important finding.

4. Female elders such as mothers-in-law were as an important

a source of advice as health workers

5. We found that mothers who reported providing prelacteal

feeds to their newborn infants and who had delivered by
cesarean section were more at risk of having an episode of
mastitis.
CONCLUSIONS

1. One in 10 mothers experienced mastitis in the first month postpartum.

2. Mastitis did not have a significant adverse effect on the duration of

exclusive breastfeeding and the rates of predominant and any breastfeeding
rates at 4 and 6 months.

3. The maternal health programs of Nepal should include screening for and
management of lactation problems during the postpartum period as
a routine maternal care practice.
THANK YOU