Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Oct 11:7:57.
doi: 10.1186/1471-2296-7-57.

A case-control study of mastitis: nasal carriage of Staphylococcus aureus

Lisa H Amir  1 , Suzanne M Garland, Judith Lumley
Affiliations

A case-control study of mastitis: nasal carriage of Staphylococcus aureus

Lisa H Amir et al. BMC Fam Pract. .

Abstract

Background: Mastitis is a common problem for breastfeeding women. Researchers have called for an investigation into the possible role of maternal nasal carriage of S. aureus in the causation of mastitis in breastfeeding women.

Methods: The aim of the study was to investigate the role of maternal S. aureus nasal carriage in mastitis. Other factors such as infant nasal S. aureus carriage, nipple damage, maternal fatigue and oversupply of milk were also investigated. A case-control design was used. Women with mastitis (cases, n = 100) were recruited from two maternity hospitals in Melbourne, Australia (emergency departments, breastfeeding clinics and postnatal wards). Breastfeeding women without mastitis (controls, n = 99) were recruited from maternal and child health (community) centres and the rooms of a private obstetrician. Women completed a questionnaire and nasal specimens were collected from mother and baby and placed in charcoal transport medium. Women also collected a small sample of milk in a sterile jar.

Results: There was no difference between nasal carriage of S. aureus in breastfeeding women with mastitis (42/98, 43%) and control women (45/98, 46%). However, significantly more infants of mothers with mastitis were nasal carriers of S. aureus (72/88, 82%) than controls (52/93, 56%). The association was strong (adjusted OR 3.23, 95%CI 1.30, 8.27) after adjustment for the following confounding factors: income, private health insurance, difficulty with breastfeeding, nipple damage and tight bra. There was also a strong association between nipple damage and mastitis (adjusted OR 9.34, 95%CI 2.99, 29.20).

Conclusion: We found no association between maternal nasal carriage of S. aureus and mastitis, but nasal carriage in the infant was associated with breast infections. As in other studies of mastitis, we found a strong association between nipple damage and mastitis. Prevention of nipple damage is likely to reduce the incidence of infectious mastitis. Mothers need good advice about optimal attachment of the baby to the breast and access to skilled help in the early postpartum days and weeks.

PubMed Disclaimer

References

    1. Kinlay JR, O'Connell DL, Kinlay S. Incidence of mastitis in breastfeeding women during the six months after delivery: a prospective cohort study. Med J Aust. 1998;169:310–312. - PubMed
    1. Vogel A, Hutchison BL, Mitchell EA. Mastitis in the first year postpartum. Birth. 1999;26:218–225. doi: 10.1046/j.1523-536x.1999.00218.x. - DOI - PubMed
    1. Inch S. Incidence of mastitis among breastfeeding women from selected Oxfordshire general practitioners practices 1993-1994. Holloway, St Barts, ; 1996.
    1. Renfrew MJ, Woolridge MW, Ross McGill H. Enabling Women to Breastfeed. A Review of Practices which Promote or Inhibit Breastfeeding - with Evidence-Based Guidance for Practice. London, The Stationery Office; 2000.
    1. World Health Organization . Mastitis: Causes and Management. Geneva, WHO/FCH/ CAH/00.13; 2000.

Publication types

MeSH terms