Cochrane · systematic review · CD007239
Interventions for preventing mastitis after childbirth
Crepinsek, MA, Taylor, EA, Michener, K, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
65
current version
GRADE rated
17
No studies
48
Included studies
NR
No studies 48 · 73.8%Ungraded 0 · 0%Very low 1 · 1.5%Low 14 · 21.5%Moderate 2 · 3.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Probiotics compared to placebo for preventing mastitis after childbirth
Population: postpartum breastfeeding women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of mastitis within 6 months postpartum Probiotics vs placebo | RR 0.51 [0.35, 0.75] | 2 studies · 399 participants | Low Downgraded: risk of bias |
Recurrence of mastitis within 12 months postpartum Probiotics vs placebo | no estimate extracted | NR | No studies |
Breast abscess within 6 months postpartum Probiotics vs placebo | no estimate extracted | NR | No studies |
Nipple damage within 6 months postpartum Probiotics vs placebo | RR 0.33 [0.11, 1.01] | 1 study · 424 participants | Very low Downgraded: risk of bias |
Duration of any breastfeeding Probiotics vs placebo | no estimate extracted | NR | No studies |
Breast pain Probiotics vs placebo | RR 0.81 [0.64, 1.01] | 2 studies · 335 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Number of women with adverse events Probiotics vs placebo | no estimate extracted | 1 study · 108 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Antibiotics compared to usual care or placebo for preventing mastitis after childbirth
Population: postpartum breastfeeding women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of mastitis within 6 months postpartum Antibiotics vs usual care or placebo | RR 0.37 [0.1, 1.34] | 3 studies · 429 participants | Low Downgraded: imprecision |
Recurrence of mastitis within 12 months postpartum Antibiotics vs usual care or placebo | no estimate extracted | NR | No studies |
Breast abscess within 6 months postpartum Antibiotics vs usual care or placebo | no estimate extracted | NR | No studies |
Nipple damage within 6 months postpartum Antibiotics vs usual care or placebo | no estimate extracted | NR | No studies |
Duration of any breastfeeding Antibiotics vs usual care or placebo | no estimate extracted | NR | No studies |
Breast pain Antibiotics vs usual care or placebo | no estimate extracted | NR | No studies |
Number of women with adverse effects Antibiotics vs usual care or placebo | no estimate extracted | NR | No studies |
Antibiotics compared to topical treatments for preventing mastitis after childbirth
Population: postpartum breastfeeding women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of mastitis within 6 months postpartum ‐ Antibiotics versus fusidic acid ointment Antibiotics vs topical treatments | RR 0.22 [0.03, 1.81] | 1 study · 36 participants | Low Downgraded: imprecision |
Incidence of mastitis within 6 months postpartum ‐ Antibiotics versus mupirocin ointment Antibiotics vs topical treatments | RR 0.44 [0.05, 3.89] | 1 study · 44 participants | Low Downgraded: imprecision |
Recurrence of mastitis within 12 months postpartum Antibiotics vs topical treatments | no estimate extracted | NR | No studies |
Breast abscess within 6 months postpartum Antibiotics vs topical treatments | no estimate extracted | NR | No studies |
Nipple damage within 6 months postpartum Antibiotics vs topical treatments | no estimate extracted | NR | No studies |
Duration of any breastfeeding Antibiotics vs topical treatments | no estimate extracted | NR | No studies |
Breast pain Antibiotics vs topical treatments | no estimate extracted | NR | No studies |
Number of women with adverse effects Antibiotics vs topical treatments | no estimate extracted | NR | No studies |
Topical treatments compared to breastfeeding advice for preventing mastitis after childbirth
Population: postpartum breastfeeding women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of mastitis within 6 months postpartum ‐ Fusidic acid ointment versus breastfeeding advice Topical treatments vs breastfeeding advice | RR 0.77 [0.27, 2.22] | 1 study · 40 participants | Low Downgraded: imprecision |
Incidence of mastitis within 6 months postpartum ‐ Mupirocin ointment versus breastfeeding advice Topical treatments vs breastfeeding advice | RR 0.39 [0.12, 1.35] | 1 study · 48 participants | Low Downgraded: imprecision |
Recurrence of mastitis within 12 months postpartum Topical treatments vs breastfeeding advice | no estimate extracted | NR | No studies |
Breast abscess within 6 months postpartum Topical treatments vs breastfeeding advice | no estimate extracted | NR | No studies |
Nipple damage within 6 months postpartum Topical treatments vs breastfeeding advice | no estimate extracted | NR | No studies |
Duration of any breastfeeding Topical treatments vs breastfeeding advice | no estimate extracted | NR | No studies |
Breast pain Topical treatments vs breastfeeding advice | no estimate extracted | NR | No studies |
Number of women with adverse events Topical treatments vs breastfeeding advice | no estimate extracted | NR | No studies |
Mupirocin ointment compared to fusidic acid ointment for preventing mastitis after childbirth
Population: postpartum breastfeeding women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of mastitis within 6 months postpartum Mupirocin ointment vs fusidic acid ointment | RR 0.51 [0.13, 2] | 1 study · 42 participants | Low Downgraded: imprecision |
Recurrence of mastitis within 12 months postpartum Mupirocin ointment vs fusidic acid ointment | no estimate extracted | NR | No studies |
Breast abscess within 6 months postpartum Mupirocin ointment vs fusidic acid ointment | no estimate extracted | NR | No studies |
Nipple damage within 6 months postpartum Mupirocin ointment vs fusidic acid ointment | no estimate extracted | NR | No studies |
Duration of any breastfeeding Mupirocin ointment vs fusidic acid ointment | no estimate extracted | NR | No studies |
Breast pain Mupirocin ointment vs fusidic acid ointment | no estimate extracted | NR | No studies |
Number of women with adverse events Mupirocin ointment vs fusidic acid ointment | no estimate extracted | NR | No studies |
Specialist breastfeeding education compared to usual care for preventing mastitis after childbirth
Population: postpartum breastfeeding women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of mastitis within 6 months postpartum Specialist breastfeeding education vs usual care | RR 0.93 [0.17, 4.95] | 1 study · 203 participants | Low Downgraded: imprecision |
Recurrence of mastitis within 12 months postpartum Specialist breastfeeding education vs usual care | no estimate extracted | NR | No studies |
Breast abscess within 6 months postpartum Specialist breastfeeding education vs usual care | no estimate extracted | NR | No studies |
Nipple damage within 6 months postpartum Specialist breastfeeding education vs usual care | no estimate extracted | NR | No studies |
Duration of any breastfeeding Specialist breastfeeding education vs usual care | no estimate extracted | NR | No studies |
Breast pain (sore nipples) Specialist breastfeeding education vs usual care | RR 0.93 [0.36, 2.37] | 1 study · 203 participants | Low Downgraded: imprecision |
Number of women with adverse events Specialist breastfeeding education vs usual care | no estimate extracted | NR | No studies |
Hydrothermally processed cereal with anti‐secretory factor‐inducing properties versus standard cereal standard cereal for preventing mastitis after childbirth
Population: postpartum breastfeeding women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of mastitis within 6 months postpartum Hydrothermally processed cereal with anti‐secretory factor‐inducing properties vs standard cereal standard cereal | RR 0.24 [0.03, 1.72] | 1 study · 29 participants | Low Downgraded: imprecision |
Recurrence of mastitis within 12 months postpartum Hydrothermally processed cereal with anti‐secretory factor‐inducing properties vs standard cereal standard cereal | RR 0.39 [0.03, 4.57] | 1 study · 7 participants | Low Downgraded: imprecision |
Breast abscess within 6 months postpartum Hydrothermally processed cereal with anti‐secretory factor‐inducing properties vs standard cereal standard cereal | no estimate extracted | NR | No studies |
Nipple damage within 6 months postpartum Hydrothermally processed cereal with anti‐secretory factor‐inducing properties vs standard cereal standard cereal | no estimate extracted | NR | No studies |
Duration of any breastfeeding Hydrothermally processed cereal with anti‐secretory factor‐inducing properties vs standard cereal standard cereal | no estimate extracted | NR | No studies |
Breast pain Hydrothermally processed cereal with anti‐secretory factor‐inducing properties vs standard cereal standard cereal | no estimate extracted | NR | No studies |
Number of women with adverse events Hydrothermally processed cereal with anti‐secretory factor‐inducing properties vs standard cereal standard cereal | no estimate extracted | NR | No studies |
Acupoint massage compared to routine care for preventing mastitis after childbirth
Population: postpartum breastfeeding women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of mastitis within 6 months postpartum) Acupoint massage vs routine care | RR 0.38 [0.19, 0.78] | 1 study · 400 participants | Moderate Downgraded: risk of bias |
Recurrence of mastitis within 12 months postpartum Acupoint massage vs routine care | no estimate extracted | NR | No studies |
Breast abscess within 6 months postpartum Acupoint massage vs routine care | no estimate extracted | NR | No studies |
Nipple damage within 6 months postpartum Acupoint massage vs routine care | no estimate extracted | NR | No studies |
Duration of any breastfeeding Acupoint massage vs routine care | no estimate extracted | NR | No studies |
Breast pain Acupoint massage vs routine care | RR 0.13 [0.07, 0.23] | 1 study · 400 participants | Moderate Downgraded: risk of bias |
Number of women with adverse events Acupoint massage vs routine care | no estimate extracted | NR | No studies |
Breast massage and low frequency pulse treatment compared to routine care for preventing mastitis after childbirth
Population: postpartum breastfeeding women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of mastitis within 6 months postpartum Breast massage and low frequency pulse treatment vs routine care | RR 0.03 [0, 0.21] | 1 study · 300 participants | Low Downgraded: risk of bias |
Recurrence of mastitis within 12 months postpartum Breast massage and low frequency pulse treatment vs routine care | no estimate extracted | NR | No studies |
Breast abscess within 6 months postpartum Breast massage and low frequency pulse treatment vs routine care | no estimate extracted | NR | No studies |
Nipple damage within 6 months postpartum Breast massage and low frequency pulse treatment vs routine care | no estimate extracted | NR | No studies |
Duration of any breastfeeding Breast massage and low frequency pulse treatment vs routine care | no estimate extracted | NR | No studies |
Breast pain Breast massage and low frequency pulse treatment vs routine care | no estimate extracted | NR | No studies |
Number of women with adverse events Breast massage and low frequency pulse treatment vs routine care | no estimate extracted | NR | No studies |