Barbara, you wrote:  >The
real incidence of lactation mastitis is still under exploration, and
researchers such as Fetherston and Amir (in Australia) and Foxman (in the
US) have published excellent articles looking at risk factors.  I'd have to
go back and review to see if there is a connection mentioned in these
articles with regard to incidence of pump use.<

I agree that the most recent lots of research about mastitis are interesting
and challenging.  So much has come out since the WHO publication on this
topic!  To respond to the above, one of the most intriguing findings of the
Foxman et al study was that there was an association with mastitis and the
use of hand pumps in the preceding week -- I think this was for women with
no previous history of mastitis and the use of a hand pump was one of the
strongest associations with subsequent mastitis.  As this was a descriptive
study, we don't know if this was a sort of reverse causality (there were bf
difficulties so women were using hand pumps to try and address) or what.  We
don't know if women with difficulties were using a particular brand or style
of hand pump or whether any women used electric pumps and there is no
association or few women used electric pumps and therefore there is no data.
Since we know from the Thompsen et al and Osterman and Rahm research that
expressing after feeds is a highly recommended practice for treatment of
mastitis, this whole question is intriguing and important for clinical
recommendations.  I certainly would be wary of selling a woman with mastitis
or drainage difficulties a hand pump in the current state of knowledge (not
that I am in the business of selling anything to anyone anyway).

Magda Sachs
Breastfeeding Supporter,
BfN, The Breastfeeding Network
http://www.breastfeedingnetwork.org.uk/




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