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Multicenter Study
. 2019 Dec 30;12(1):105.
doi: 10.3390/nu12010105.

Subclinical Mastitis in a European Multicenter Cohort: Prevalence, Impact on Human Milk (HM) Composition, and Association with Infant HM Intake and Growth

Tinu Mary Samuel  1 , Carlos Antonio De Castro  2 , Stephane Dubascoux  1 , Michael Affolter  1 , Francesca Giuffrida  1 , Claude Billeaud  3 , Jean-Charles Picaud  4   5 , Massimo Agosti  6 , Isam Al-Jashi  7 , Almerinda Barroso Pereira  8 , Maria Jose Costeira  9 , Maria Gorett Silva  10 , Giovanna Marchini  11 , Thameur Rakza  12 , Kirsti Haaland  13 , Tom Stiris  13 , Silvia-Maria Stoicescu  14 , Cecilia Martínez-Costa  15 , Mireilla Vanpee  11 , Magnus Domellöf  16 , Castañeda-Gutiérrez Euridice  1 , Sagar Kiran Thakkar  2 , Irma Silva-Zolezzi  2
Affiliations
Multicenter Study

Subclinical Mastitis in a European Multicenter Cohort: Prevalence, Impact on Human Milk (HM) Composition, and Association with Infant HM Intake and Growth

Tinu Mary Samuel et al. Nutrients. .

Abstract

Background: Subclinical mastitis (SCM) is an inflammatory condition of the mammary gland. We examined the effects of SCM on human milk (HM) composition, infant growth, and HM intake in a mother-infant cohort from seven European countries. Methods: HM samples were obtained from 305 mothers at 2, 17, 30, 60, 90, and 120 days postpartum. SCM status was assessed using HM Sodium (Na): Potassium (K) ratio >0.6. Levels of different macro- and micronutrients were analyzed in HM. Results: SCM prevalence in the first month of lactation was 35.4%. Mean gestational age at delivery was lower and birth by C-section higher in SCM mothers (p ≤ 0.001). HM concentrations of lactose, DHA, linolenic acid, calcium, and phosphorous (p < 0.05 for all) was lower, while total protein, alpha-lactalbumin, lactoferrin, albumin, arachidonic acid to DHA ratio, n-6 to n-3 ratio and minerals (iron, selenium, manganese, zinc, and copper) were higher (p < 0.001 for all) in mothers with SCM. There were no differences in infant growth and HM intake between non-SCM and SCM groups. Conclusion: We document, for the first time, in a large European standardized and longitudinal study, a high prevalence of SCM in early lactation and demonstrate that SCM is associated with significant changes in the macro- and micronutrient composition of HM. Future studies exploring the relation of SCM with breastfeeding behaviors and developmental outcomes are warranted.

Keywords: European population; human milk; longitudinal study; milk macronutrients; subclinical mastitis.

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Conflict of interest statement

T.M. Samuel, C.A. De Castro, S. Dubascoux, M. Affolter, F. Giuffrida, E. Castañeda-Gutiérrez, S.K. Thakkar and I. Silva-Zolezzi are employees of Nestec Ltd. C. Billeaud, J.C. Picaud, M. Agosti, I. Al-Jashi, A.B. Pereira, M.J. Costeira, M.G. Silva, G. Marchini, T. Rakza, K. Haaland, T. Stiris, S.M. Stoicescu, C. Martínez-Costa, M. Vanpee and M. Domellöf received funding from Nestec Ltd. to conduct the study.

Figures

Figure 1
Figure 1
Flowchart outlining number of mothers per group at each visit. The Subclinical mastitis (SCM) group in this flowchart indicates mothers with at least one incident of SCM in the first month.
Figure 2
Figure 2
Frequency of SCM in a European cohort of lactating mothers across four months of lactation.
Figure 3
Figure 3
Concentrations of individual proteins in HM across lactation by presence or absence of SCM. * Statistical significance of the difference between mothers with SCM and without SCM for a particular time point with p value <0.05, ** p value for overall difference between groups <0.001.
Figure 4
Figure 4
Concentrations of fatty acids in HM across lactation by presence or absence of SCM. * Statistical significance of the difference between mothers with SCM and without SCM for a particular time point with p value <0.05, ** p value for overall difference between groups <0.001.
See this image and copyright information in PMC

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