Incidencia y factores de riesgo del dolor durante la lactanciaestudio prospectivo en una consulta de pediatría en atención primaria

Abstract

Introduction: Breastfeeding pain constitutes one of the main causes of undesired weaning, but the studies about its etiopathogenesis are scarce. The objective of this work was to determine the incidence of breast pain during lactation and the risk factors involved in its development. Subjects and methods: A prospective and observational study was conducted, including 63 mother-child pairs. The incidence and intensity of pain was evaluated (Visual Analog Scale [VAS]). The breastfeeding technique and ankyloglossia (tongue-tie) in the infant, among other risk factors potentially involved in pain, were systematically assessed and microbiological analysis of milk samples was also performed. Results: Breast pain (VAS ≥3) lasting more than a week was reported in 65% of lactating mothers, and among them, 29% experienced pain for more than two months. The breastfeeding technique and ankyloglossia (tongue-tie) in the infant were not related with higher risk of pain, however, a positive milk culture was a very significant risk factor for breast pain (p <0.0001). The same species were isolated in samples of breastfeeding mothers with pain and without pain (Staphylococcus epidermidis, S. aureus, viridans group streptococci, Rothia mucilaginosa and Corynebacterium spp.), but their concentration was significantly higher in the pain group. Candida spp. were not isolated in any sample. Conclusions: The microbiological analysis of milk samples is key to ensure an appropriate and effective breastfeeding pain management.