Journal Article

Breast Health Problems Are Rare in Both HIV-Infected and HIV-Uninfected Women Who Receive Counseling and Support for Breast-Feeding in South Africa

R. M. Bland, R. Becquet, N. C. Rollins, A. Coutsoudis, H. M. Coovadia and M. L. Newell

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 45, issue 11, pages 1502-1510
Published in print December 2007 | ISSN: 1058-4838
Published online December 2007 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/523320
Breast Health Problems Are Rare in Both HIV-Infected and HIV-Uninfected Women Who Receive Counseling and Support for Breast-Feeding in South Africa

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Background. Breast problems, including mastitis, can interfere with the duration and exclusivity of breast-feeding. However, there are no large prospective studies documenting the prevalence, duration, and timing of such problems in breast-feeding women, particularly those who are infected with human immunodeficiency virus (HIV).

Methods. Women enrolled prenatally underwent a breast-feeding counseling intervention until 6 months after delivery. Breast health problems were documented per breast for 180 days after delivery, with 14-day recall histories.

Results. Breast health problems were rare, and there were no significant differences between HIV-infected and HIV-uninfected women for any of the following conditions: engorgement, 39 HIV-infected women (3.5%) versus 33 HIV-uninfected women (2.7%; P = .30); breast thrush, 17 (1.5%) versus 12 (1.0%; P = .25); bleeding nipple, 6 (0.5%) versus 4 (0.3%; P = .45); and mastitis/abscess, 11 (1.0%) versus 6 (0.5%; P = .17). Most problems occurred during the first month after birth, with few additional mothers experiencing problems after this point: at 1 and 6 months, 13% and 17% of all mothers, respectively, had experienced a minor or major breast health problem, including sore nipples. Women who had not exclusively breast-fed their infants were more likely to experience any of the breast health problems than were women who had exclusively breast-fed their infants (time-dependent variable; adjusted odds ratio, 1.46; 95% confidence interval, 1.13–1.87; P = .003). HIV-infected women who experienced any serious breast health problem (i.e., bleeding nipple, pus oozing from a nipple or breast, or mastitis/abscess) were 3.55 times (95% confidence interval, 0.86–14.78 times; P = .08) more likely to transmit HIV postnatally to their infant.

Conclusions. With encouragement to exclusively breast-feed, women experienced few breast health problems. When those problems did occur, HIV-infected women with bleeding nipple, pus oozing from a nipple or breast, or mastitis/abscess were more likely to transmit HIV to their infants.

Journal Article.  3571 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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