A study of Breast Abscesses among Breastfeeding mothers.

Abstract

It has been observed that breast abscesses are a common surgical condition at the University Teaching Hospital Female Casualty Ward. A pilot study on common breast problems in the female casualty records, covering the period of March 1997 to March 1998 showed that 720 breast abscess were common among breastfeeding mothers. Therefore, the study attempted to document factors contributing to development of breast abscesses among breastfeeding mothers admitted at the University Teaching Hospital Female Casualty Ward. A cross section descriptive study design was used on 112-study population. Demographic data included socio-economic status, obstetrical history, preparation for breastfeeding during pregnancy, management of breastfeeding following child birth, maternal and infant health status prior to development of the breast abscess and laboratory investigations on culture and sensitivity, the status for HIV and anaemia. The findings demonstrated that majority of mothers were first time (29.3%) or second time (24.9%) mothers with ages ranging between 15-24 (62 %), no education or very low literacy levels (71 %) residing in crowded and densely populated areas (76.8%) and poor income below poverty line (86.7%). Breast abscess were found to be common among mothers with younger infants in the first 12 weeks of postnatal period (72.4 %). Appropriate breastfeeding education and breastfeeding support following childbirth were found to be grossly deficient in 94.6% of the mothers. Staphyloccocal aureus infection was found to be responsible for 94.6% of the organisms isolated. In this study 64.3% of the study population was HIV sero-positive. Anaemia was found in 44.6% of women presenting with abscesses. With regard to HIV infection, findings bear very important implications on the general mothers' health whose HIV sero status is unknown. In the context of Mother-to-Child transmission (MTCT) of HIV during pregnancy, labor, delivery and post nataly through breastfeeding, one of the strong recommendations is to urgently integrate MTCT into all Baby Friendly Hospital Initiative (BFHI) activities and intensify appropriate breastfeeding education and support to all mothers following child birth in order to prevent unnecessary breast conditions in all breastfeeding mothers. The factors contributing to the development of breast abscess were noted to be socio-economic status, age, parity, HIV and nutritional status. Study findings on the lack of appropriate breastfeeding education and support following childbirth have an impact on factors contributing to development of breast abscesses.