Literature review for - Flourish Paediatrics

Applicability
Satisfactory Results are applicable to Australian women
(Vogel, Hutchison et al. 1999; Amir, Forster et al. 2004; Kvist, Hall-Lord et al. 2007)
The studies included in the body of evidence statement are shown in the Table below
Notes:
Prevention of breast abscess during lactation
The WHO stated that breast abscess is largely preventable through appropriate breastfeeding
technique and treating conditions that lead to milk stasis; e.g. engorgement, blocked duct and
nipple soreness, promptly (WHO 2000)
No evidence base was developed for the use of antibiotics during inflammatory conditions of
the breast to prevent breast abscess due to the lack of quality studies.
The authors of a large cross-sectional study in Sweden stated that low incidence of abscess
formation (0.1% in their study of 1,454,068) raised the question as to whether antibiotic
therapy is appropriate for all mothers with symptoms of breast inflammation (Kvist and
Rydhstroem 2005).
Two trials met the inclusion criteria for the Cochrane review on Antibiotics for mastitis in
breastfeeding women. One RCT conduced in 1984 on 213 women comparing no treatment,
breast emptying, and antibiotic therapy on mastitis found 11% of mastitis cases with no
intervention developed abscess, while none in the group treated with antibiotic therapy
suffered from any abscess. Authors of the Cochrane review conclude that more high-quality,
recent studies are required to confirm or refute the effectiveness of antibiotic therapy for the
treatment of lactational mastitis (Jahanfar, Ng et al. 2009).
Management of Breast Abscess during lactation
No evidence base was developed for the management of breast abscess during lactation due
to the lack of quality studies.
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