Study of Acupuncture and Care Interventions for the Treatment of Breast Inflammation During Breastfeeding

NCT ID: NCT00405158

Last Updated: 2006-12-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

210 participants

Study Classification

INTERVENTIONAL

Study Start Date

2002-01-31

Study Completion Date

2004-03-31

Brief Summary

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The objective of the study was to test the hypothesis that acupuncture treatment hastens recovery time from inflammatory symptoms of the breast during breastfeeding. 205 mothers with 210 cases of breast inflammation (commonly called "mastitis") during breastfeeding were randomly assigned to one of three treatment groups. There were two groups where acupuncture was used and one without acupuncture. The mothers symptoms were recorded at the onset of health care contact and daily until recovery. All care interventions given, including antibiotic therapy, were monitored. Women who participated were asked to leave a breast milk sample to test for bacterial growth. It was found that acupuncture did not shorten the women's contacts with health care services but did improve their symptoms on contact days 3 and 4. It was seen in this study that only 15 % of women were prescribed antibiotics which was a very low rate of prescription compared to USA, Canada, Australia, Turkey and New Zealand where up to 100% are given antibiotics. Seven women (3.3% of those in the study) developed a breast boil and this is a similar number to a study in Australia where many more were treated by antibiotics. This could mean that many women throughout the world are given antibiotics when in fact they may recover without them. This is an important finding in relation to the fight against antibiotic resistant bacteria.

Detailed Description

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Objectives: to further compare acupuncture treatment and care interventions for the relief of inflammatory symptoms of the breast during lactation and to investigate the relationship between bacteria in the breast milk and clinical signs and symptoms.

Design: randomised, non-blinded, controlled trial of acupuncture and care interventions.

Setting: a midwife-led breast-feeding clinic in Sweden.

Participants: 205 mothers with 210 cases of inflammatory symptoms of the breast during lactation agreed to participate. The mothers were randomly assigned to one of three treatment groups, two of which included acupuncture amongst the care interventions and one without acupuncture. All groups were given essential care. Protocols, which included scales for erythema, breast tension and pain, were maintained for each day of contact with the breast-feeding clinic. A Severity Index (SI) for each mother and each day was created by adding together the scores on the erythema, breast tension and pain scales. The range of the SI was 0 (least severe) to 19 (most severe).

Findings: There was no significant difference in numbers of mothers in the treatment groups with the lowest possible score for severity of symptoms on contact days 3, 4 or 5. There were no statistically significant differences between the treatment groups for number of contact days needed until the mother felt well enough to discontinue contact with the breast-feeding clinic or for number of mothers prescribed antibiotics. There were significant differences in the mean SI scores on contact days 3 and 4 between the non-acupuncture group and the two acupuncture groups. Mothers with less favourable outcomes (≥ 6 contact days, n = 61) were, at first contact with the midwife more often given advice on correction of the baby's attachment to the breast. An obstetrician was called to examine 20 % of the mothers and antibiotic therapy was prescribed for 15 % of the study population. The presence of Group B streptococci in the breast milk was related to less favourable outcomes.

Key conclusions and implications for practice: If acupuncture treatment is acceptable to the mother, this, together with care interventions such as correction of breast-feeding position and babies' attachment to the breast might be a more expedient and less invasive choice of treatment than the use of oxytocin nasal spray. Midwives, nurses or medical practitioners with specialist competence in breast feeding should be the primary care providers for mothers with inflammatory symptoms of the breast during lactation. The use of antibiotics for inflammatory symptoms of the breast should be closely monitored in order to help the global community reduce resistance development among bacterial pathogens.

Conditions

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Mastitis

Keywords

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Lactation mastitis Breast inflammation Breastfeeding Care interventions Acupuncture treatment Antibiotic therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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Acupuncture treatment

Intervention Type PROCEDURE

Administration of oxytocin nasal spray

Intervention Type PROCEDURE

Improved breast milk removal

Intervention Type PROCEDURE

Warmth applied to breasts

Intervention Type PROCEDURE

Breast massage

Intervention Type PROCEDURE

Anti-pyretic medication, paracetamol

Intervention Type DRUG

cefadroxil

Intervention Type DRUG

penicillin

Intervention Type DRUG

flucloxacillin

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Lactating mothers with symptoms of breast inflammation
* Any mixture of increased breast tension, fever, breast erythema, lumps in the breast

Exclusion Criteria

* Non-Swedish speaking
* Psychiatric illness
* Hemorrhagic disease
* Prosthetic heart valves
* Skin infections
* Hepatitis B
* HIV positive.
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Karlstad University

OTHER

Sponsor Role lead

Principal Investigators

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Linda J Kvist, PhD

Role: PRINCIPAL_INVESTIGATOR

Karlstads University

Bodil Wilde Larsson, PhD

Role: STUDY_DIRECTOR

Karlstad University

Locations

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Dept Obstetrics & Gynecology, Helsingborg Hospital

Helsingborg, Skåne County, Sweden

Site Status

Countries

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Sweden

References

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Kvist LJ, Hall-Lord ML, Rydhstroem H, Larsson BW. A randomised-controlled trial in Sweden of acupuncture and care interventions for the relief of inflammatory symptoms of the breast during lactation. Midwifery. 2007 Jun;23(2):184-95. doi: 10.1016/j.midw.2006.02.003. Epub 2006 Oct 18.

Reference Type BACKGROUND
PMID: 17052823 (View on PubMed)

Related Links

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http://www.kau.se

Karlstad University Webb page

Other Identifiers

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84839

Identifier Type: -

Identifier Source: org_study_id