Literature review for - Flourish Paediatrics

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A literature review conducted by Kvist aimed to clarify the use of the term mastitis in scientific literature. Kvist searched articles on lactation mastitis published in English between 1998- 2008. Clarification of the term mastitis was carried out on each of the 18 articles that met the inclusion criteria. There was inconsistency between the studies on the definition of mastitis. The findings signify the need for an international consensus on the definition of the term and the diagnosis of the condition. The variety of definitions that exist for mastitis could also part explain the contradicting results that are sometimes seen on prevalence rates, risk factors and effectiveness of treatment methods for mastitis (Kvist 2010). THE PREVENTION OF MASTITIS IN BREASTFEEDING WOMEN What preventative strategies are effective in reducing the incidence and recurrence of mastitis in lactating women? Evidence statement Grade Component Rating Notes No pharmacological or non-pharmacological preventative methods are associated with a reduced occurrence of mastitis in breastfeeding women D Evidence Base Poor 1 Cochrane review (P); no statistically significant evidence that any preventative interventions is effective in regards to the occurrence of mastitis or breastfeeding exclusivity and duration Consistency Satisfactory All five RCTs included in the Cochrane Review reported the preventative intervention under study had no significant differences in the incidence of mastitis or on breastfeeding outcomes. Clinical impact Poor No trial provides sufficient evidence on any intervention to justify widespread uptake of that intervention. Generalisability Applicability (Crepinsek, Crowe et al. 2010) Satisfactory Cochrane review included RCTs conducted in developing and developed countries. 1 RCT conducted in Australia Satisfactory Results are applicable to Australian women The review included in the body of evidence statement is shown in the Table below Notes on mastitis in lactating women 199
Three studies reported on the occurrence rate of mastitis during the postpartum period. However due to the lack of high quality studies there was insufficient evidence to form a body of evidence statement. The three studied that were reviewed indicated a high occurrence rate of mastitis early in the postpartum period A cohort study in Australia reported 51% of mastitis cases occurred within the first two weeks postpartum (Fetherston 1997). The cohort study by Scott and colleagues found 53% of initial mastitis episodes and 43% of all episodes occurred during the first four weeks postpartum (Scott, Robertson et al. 2008). Consistent with these rates are the results from a cohort study by Amir and colleagues that found 54% of mastitis episodes occurred in first 4 weeks (Amir, Forster et al. 2007) . All studies, with the exception of one, did not associate mastitis with poorer breastfeeding outcomes. The majority of studies found no significant difference between incidence of mastitis and breastfeeding duration, and some even found women who had had mastitis were more likely to breastfed for longer than those who did not have mastitis (Vogel, Hutchison et al. 1999; Scott, Robertson et al. 2008). The one study that linked mastitis with poorer breastfeeding outcomes reported 18% of the women who had stopped breastfeeding by three months cited mastitis as the reason for stopping (Fetherston 1997). Alarmingly, the cohort study conducted by Scott and colleagues found a small portion of women (approximately 10%) were inappropriately advised to either stop breastfeeding from the affected breast, or altogether when they had mastitis (Scott, Robertson et al. 2008). The Cochrane review by Jahanfar and colleagues aimed to examine the effectiveness of antibiotic therapies in the treatment of mastitis. After a thorough research of the literature two RCTs met the inclusion criteria (Jahanfar, Ng et al. 2009). One study compared two different antibiotics (amoxicillin vs. cephradine) and found no differences between the two antibiotics for symptom relief. The second study compared no treatment, breast emptying, and antibiotic therapy, with breast emptying suggesting more rapid symptom relief with antibiotics. Jahanfar & Ng concluded there is very little evidence on the effectiveness of antibiotic therapy, and more research is needed (Jahanfar, Ng et al. 2009). A narrative review by Abou- Dakn and colleagues investigated 16 studies on the recommendations for the diagnosis and therapy of breast diseases during lactation also concluded that there is insufficient evidence to confirm or refute the effectiveness of the different therapies for the treatment of mastitis (Abou-Dakn, Richardt et al. 2010). 200
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Infant Feeding Guidelines for Healt
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One of the responses of the Austral
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Table of Contents Introduction ....
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Goat’s milk .....................
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period of this review will generall
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Infant formula - Preparation, use a
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Protein levels of infant formula. F
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a. Will the use of a heavier refere
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Time to first feed and breastfeedin
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controlled for in multivariate logi
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the baby, or for suturing the mothe
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Impact of delivery method on breast
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Studies used to make evidence state
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For those who were fully breastfeed
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Effect on risk 0.56-0.88) Assisted
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significant Breastfeeding initiatio
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Results Adj OR never breastfed Assi
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Birth weight and breastfeeding If t
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3500-3999 vs 3000-3499 1.00 (95% CI
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Population/study information Perth,
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Any breastfeeding duration No adjOR
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cohort study reported no associatio
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Results [8] Intro of formula at 4 w
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Clinical 1 1 1 importance Clinical
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6. If mother-baby separation is una
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Studies reviewed to make evidence s
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Reference Scott JA, Binns CW, Oddy
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Effect on risk There was no associa
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infant Clinical 1 1 1 4 importance
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Reference Qiu et al Asia Pac J Clin
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Social support (other than fathers)
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pregnancy interventions on breastfe
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Reference Scott JA, Landers MCG, Hu
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weeks, 3 months & 6 months postpart
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Quality P O P Results Breastfeeding
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analysis analysis Effect on risk No
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Location (rural vs urban) and breas
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Effect on risk New Territories not
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Socioeconomic status Sufficient evi
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Quality P P O P Results Adj OR any
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Whether the mechanism for this asso
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obesity and infant feeding intentio
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Parity and Breastfeeding Parity has
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Quality P P P P Results No signific
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discharge. Quality P P P P Results
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Effect on risk There was not associ
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Effect on risk No effect of parity
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For Australian mothers 5 studies fo
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25-29 1.710 (1.085, 2.698) ≤24 1.
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30-34: 0.87 (95%CI 0.64-1.18) Adjus
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Clinical 1 2 1 relevance Generalisa
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Reference Binns CW, Gilchrist D, Gr
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Population/study information Infant
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Intervention/ comparator 40 years v
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Maternal education and breastfeedin
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Effect on risk Mothers who complete
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significant independent association
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Demand feeding, Rooming in and brea
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Effect on risk There was no signifi
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1991. Quality P P P P Results No sp
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Cultural differences on Exercise an
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During pregnancy, women should avoi
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findings of this study support the
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N 14 countries 3032 17 359 singleto
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8. Encourage breastfeeding on deman
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Breastfeeding and SIDS BREASTFEEDIN
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descriptive) RESULTS Outcome EXTERN
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Additional Notes 1. Clinical Eviden
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Use of Pacifiers for the Prevention
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American Academy of Pediatrics Poli
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Parslow et al. 2004). In addition,
Page 155 and 156: Studies used to make evidence state
Page 157 and 158: N Population/study information 570
Page 159 and 160: Both the Baby Friendly Hospital Ini
Page 161 and 162: lanolin, aerosol spray, ointment, f
Page 163 and 164: Incidence of nipple pain/trauma No
Page 167 and 168: Effect on risk Sore nipples, althou
Page 169 and 170: Systemic antibiotics are recommende
Page 171 and 172: Results Routine Care Versus Heat Ve
Page 173 and 174: anticipatory guidance with regard t
Page 175 and 176: In a cohort of 280 mother-infant pa
Page 177 and 178: months in 1987-9. Completed two wri
Page 179 and 180: Population/study information Sample
Page 181 and 182: Nipple Shield Use Search results Th
Page 183 and 184: Other Nipple Problems Eczema and De
Page 185 and 186: Raynaud’s Phenomenon of the Nippl
Page 187 and 188: Table. Management of breastmilk ins
Page 189 and 190: Effect on risk Factor analysis sugg
Page 191 and 192: Definition of breastfeeding Interve
Page 193 and 194: Reference Hurley et al. 2008 Gatti
Page 195 and 196: y test-weighing) Clinical 1 1 1 imp
Page 197 and 198: Engorgement of the Breast Search re
Page 199 and 200: more frequently prior to the recurr
Page 203 and 204: Reference Mangesi & Dowswell 2010 C
Page 205: Inflammatory conditions of the brea
Page 209 and 210: In the management of mastitis, the
Page 211 and 212: Quality 0 0 P Results The cumulativ
Page 213 and 214: was an intention to breastfeed. Par
Page 215 and 216: Level of evidence I (a) I (aetiolog
Page 217 and 218: Further adequately powered research
Page 219 and 220: Applicability Satisfactory Results
Page 223 and 224: Reference Kvist et al. 2007 Kvist e
Page 225 and 226: egarding aspiration technique Effec
Page 227 and 228: Many epidemiological studies have d
Page 229 and 230: normal functioning (Horowitz and Go
Page 231 and 232: • Ask mothers if they are losing
Page 235 and 236: the first 3 months postpartum, with
Page 237 and 238: Effect on risk This variability is
Page 239 and 240: In a US study of 802 women they fou
Page 241 and 242: Studies used to determine the risk
Page 243 and 244: A predictive relationship was consi
Page 245 and 246: The effect size of social support i
Page 247 and 248: weeks of delivery Four validated se
Page 249 and 250: growth faltering N > 22,000 929 chi
Page 251 and 252: Breast Refusal Search results The i
Page 253 and 254: Prevalence Rates of Excessive Cryin
Page 255 and 256: Regurgitation, gastroesophageal ref
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(Dwyer and Ponsonby 2009). Medicati
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ultrasonically. Real time ultrasoni
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Reference Heine et al. (2006) Cheri
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There was no significant associatio
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positioning strategies. The treatme
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Reference van Wijk et al. (2007) Co
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Generalisability Y Y- Italy Y Appli
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myenteric plexus Quality P P N Resu
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comparator N Population/study infor
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Effect on risk There were fewer adv
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Component Rating Notes Evidence Bas
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and/or difficulty of the baby latch
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Reference Dollberg et al. 2006 Srin
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Effect on risk Frenotomy alleviates
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Studies used to make the statement
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Notes on postpartum weight loss Ip
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Main results: Twelve studies met th
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Storage of Expressed Breastmilk Wha
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4. Storage of Expressed Breastmilk
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Expression and Breastfeeding durati
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duration) Clinical 1 1 1 importance
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VI Breastfeeding in specific situat
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Mothers currently using illicit dru
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Summary of the evidence The effect
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showing a negative association with
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Population/study information breast
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Effect on risk response relationshi
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pregnancy Quality P P P P Results A
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Reference Forster DA, McLachlan HL
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who did not stop smoking. duration
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-1, 5) Not breastfeeding: 1% (95% C
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≥6 vs non-smoker Adj OR (95%CI) n
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Larger hospitals - mothers recruite
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The Merck Manual online version als
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Sufficient evidence was found to ma
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Does return to work negatively affe
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Returned to work (
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N [5] 2079 of 3670 questionnaires r
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Reference [1] Forster DA, McLachlan
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technical 0.32 (95%CI 0.25-0.42) Se
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Reference Scott JA, Aitkin I, Binns
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Contraception and Breastfeeding The
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Authors’ conclusions: Postpartum
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ich countries where there it is aff
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eview by (Bulteel and Henderson 200
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Galactosaemia in Infants Search res
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of birth. Every effort should be ma
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Hepatitis C and HIV co-infected mot
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significantly affect HCV transmissi
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The PKU handbook includes the follo
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Tuberculosis and Breastfeeding Sear
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Syphillis in Breastfeeding Mothers
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paediatricians (Australian College
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the Cochrane Central Register of Co
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Objectives: To determine the effect
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Objectives: In newborn infants with
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information on bottle-feeding and d
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Cow’s Milk Search results The ini
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The SLR by Wijndaele and colleagues
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infants were fed formula for 1 mont
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Quality 0 (No to 6.2 and 7.4 P P 0
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Reference Conn et al. 2009 Couper e
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eastfed Fe intake was inadequate fo
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England. After the birth, a short q
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food weighing (BM: n =21; BCM: n =
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Population/study information Sample
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positive stools upon cow milk feedi
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data were collected from the parent
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Applicability Y- Denmark Y - Vietna
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milk during infancy can result in s
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X Infant feeding and later Outcomes
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Overall quality assessment (Positiv
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finally recruited. Outcome measure
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Intervention Comparator N Populatio
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elevance Generalisability Y N Y App
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Current advice from the Australasia
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elevant food allergens altogether.
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71. However, it should be recognise
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Obesity and infant feeding The dura
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) Around six months c) Around six m
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The Paediatrics & Child Health Divi
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Belarus found that during the perio
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The American Academy of Pediatrics
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efore age 4 months was associated w
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isk of obesity at age 7 yrs. while
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Effect on risk Positive Positive Ne
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Results Any breastfeeding reduced t
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eastfeeding promotion intervention
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Effect on risk Negative Negative Ne
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Additional Notes Horta: Meta-analys
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socioeconomic status strongly influ
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Breastfeeding and Obesity Notes Whi
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Breastfeeding and Bowel Disease: Co
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Notes on Coeliac Disease and IBD -
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This paper is not directly related
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Table 1 Death rates from coronary a
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Figure 1 Hazard ratios for coronary
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These adaptations permanently ‘re
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postnatal growth—programs to avoi
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“Health care professional’ - a
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7.3. No financial or material induc
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Appendix 460
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9 FISH (S1.1) Data was extracted fr
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allergies. Assigned to n-3 egg, no
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Table 13.1 Studies used to make evi
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14 SUGARS (S1.1) SUGARS and DENTAL
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Effect on risk (Increase/None /Prot
Page 479 and 480:
Page 481 and 482:
Clinical importance Clinical releva
Page 483 and 484:
Population/study information [6] Ch
Page 485 and 486:
Page 487 and 488:
Page 489 and 490:
obesity (P=0.008) and 6.2-fold risk
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quality and were both conducted in
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associated with a decreased risk of
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The systematic review was of very p
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Effect on risk (0.45-76.85). (OR ra
Page 499 and 500:
excluded. from the Denver metropoli
Page 501 and 502:
21 DIETARY PATTERNS (U1.1) What die
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Applicability Excellent Studies con
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or Neutral) plus descriptive) RESUL
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Table 24.2 Summary used to make evi
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Statistical analysis methods Overal
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from 8 - 12 months (outcome three);
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infants with low z-scores provided
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Kajosaari 1983 and Oddy 1999 report
Page 517 and 518:
of upper respiratory infectionRR 0.
Page 519 and 520:
still be managed individually so th
Page 521 and 522:
Length of follow-up Outcome(s) meas
Page 523 and 524:
0.94 (95% CI 0.87 -1.01). Professio
Page 525 and 526:
Conclusion Additional professional
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Outcome(s) measured INTERNAL VALIDI
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Conclusion PIM is one of the most c
Page 531 and 532:
Table 24.3 Summary used to make evi
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BREASTFEEDING AND SUDDEN INFANT DEA
Page 535 and 536:
RESULTS Outcome EXTERNAL VALIDITY G
Page 537 and 538:
ALCOHOL, CAFFEINE AND BREASTFEEDING
Page 539 and 540:
Table 26.1 Summary of studies to ma
Page 541 and 542:
SELENIUM AND BREASTFEEDING OUTCOMES
Page 543 and 544:
Table 26.2 Summary of studies used
Page 545 and 546:
FACTORS ASSOCIATED WITH ENHANCED BR
Page 547 and 548:
Total number of participants Popula
Page 549 and 550:
weight loss).Comparison one: contro
Page 551 and 552:
month) (outcome five). For the 8-12
Page 553 and 554:
study also provided data on head ci
Page 555 and 556:
found no reduction in risk of a pos
Page 557 and 558:
espiratory tract infection RR 1.07
Page 559 and 560:
Affiliation/so urce of funds Univer
Page 561 and 562:
Perceived Insufficient Milk (PIM) T
Page 563 and 564:
Overall quality assessment (Positiv
Page 565 and 566:
professional support to be effectiv
Page 567 and 568:
EXTERNAL VALIDITY Generalisabil ity
Page 569 and 570:
people together was specific to bre
Page 571 and 572:
References Abdulwadud Omar, A., & S
Page 573 and 574:
Gatti, L. 2008, "Maternal perceptio
Page 575 and 576:
Poole, J. A., Barriga, K., Leung, D
Page 577 and 578:
Monitoring Breastfeeding in Austral
Page 579 and 580:
Labiner-Wolfe, Judith, Sara B. Fein
Page 581 and 582:
Issues in selecting a growth refere
Page 583 and 584:
that breastfeeding, with exclusive
Page 585 and 586:
they noted that “during the first
Page 587 and 588:
lower percentiles (0.4 and 2 percen
Page 589 and 590:
Breastfeeding is an integral part o
Page 591 and 592:
Royal Australian College of General
Page 593 and 594:
feeding, the AAP firmly adheres to
Page 595 and 596:
If an infant is not breastfed, or i
Page 597 and 598:
Interventions to Promote Breastfeed
Page 599 and 600:
ethnicity or maternal age cannot be
Page 601 and 602:
three months, interventions involvi
Page 603 and 604:
Data Collection and Analysis: We us
Page 605 and 606:
Major Reviews of Infant Feeding 200
Page 607 and 608:
Proportion of adult smokers who hav
Page 609 and 610:
figures indicate that we have littl
Page 611 and 612:
Funding has also been allocated to
Page 613 and 614:
National Longitudinal Survey of Chi
Page 615 and 616:
608
Page 617 and 618:
infectious diseases. There is a lar
Page 619 and 620:
In Queensland, according to the 200
Page 621 and 622:
eastfeeding at 6 months were among
Page 623 and 624:
gestational age or who have experie
Page 625 and 626:
Ten Steps to Successful Breastfeedi
Page 627 and 628:
620
Page 629 and 630:
622
Page 631 and 632:
deficiency has also been associated
Page 633 and 634:
PAHO Guiding Principles for Complem
Page 635 and 636:
Breastfeeding Rates in Australia A
Page 637 and 638:
Population/ study information A tot
Page 639 and 640:
Population/ study information The s
Page 641 and 642:
Type of study Breastfee ding defini
Page 643 and 644:
References Abou-Dakn, M., A. Richar
Page 645 and 646:
Barclay, A. R., R. K. Russell, et a
Page 647 and 648:
Clark, P. M. (1998). "Programming o
Page 649 and 650:
Eglash, A. (2005). "ABM Protocol #8
Page 651 and 652:
Griffiths, D. M. (2004). "Do tongue
Page 653 and 654:
Howard, C. R., N. Lanphear, et al.
Page 655 and 656:
Labiner-Wolfe, J., S. B. Fein, et a
Page 657 and 658:
National Institute of Clinical Stud
Page 659 and 660:
Rasmussen, K. and C. Kjolhede (2004
Page 661 and 662:
Stettler, N. (2007). "Nature and st
Page 663 and 664:
Whitaker-Worth, D. L., V. Carlone,
Page 665 and 666:
INDEX A Abscess ...................
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