Probiotics help reduce mastitis during lactation

For breastfeeding mothers, taking probiotics may help decrease the likelihood of developing mastitis and related symptoms during lactation, reports a recent meta-analysis.

The researchers retrieved a total of six randomized controlled trials (RCT) from the databases of PubMed, Cochrane Library, Web of Science, Embase, CNKI, and Wanfang. Overall, 1,197 participants were assessed, of whom 727 had received the probiotic intervention during the prenatal period. Probiotics were given either as a mixture of two strains or as single-strain doses.

Pooled analysis of three studies showed that using probiotics reduced the risk of developing mastitis by more than half (risk ratio [RR], 0.49, 95 percent confidence interval [CI], 0.35–0.69; p<0.0001). A similar effect was reported for breast pain, according to two studies, though the benefit was only of borderline significance (RR, 0.81, 95 percent CI, 0.64–1.01; p=0.07).

Among women who developed mastitis, taking probiotics led to a significantly lower milk bacterial count, as reported by a pooled analysis of five studies (mean difference, –0.89, 95 percent CI, –1.34 to –0.43). This result remained stable after sensitivity analysis.

In terms of safety, the included studies reported the occurrence of flatulence and vaginal candidiasis following oral probiotics, though it remains unclear whether these are definitely related to the intervention or if these occur at higher rates relative to controls.

“There is still a lack of uniformity … in the selection of probiotic strains and intervention doses, and the diagnostic criteria and efficacy evaluation indicators of lactation mastitis are inconsistent, all of which are problems. The need for high-quality RCTs on probiotics and mastitis to support this result still remains,” the researchers said.