{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T14:23:45Z","timestamp":1782138225078,"version":"3.54.5"},"reference-count":36,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2014,1,4]],"date-time":"2014-01-04T00:00:00Z","timestamp":1388793600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Breastfeeding Medicine"],"published-print":{"date-parts":[[2014,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Although breast pain remains a common cause of weaning, controversy exists regarding the etiology of chronic pain. Prospective studies are needed to define optimal treatment regimens. We evaluated patient history, exam, and bacterial cultures in breastfeeding women with chronic breast pain. We compared pain resolution and breastfeeding complications in patients responding to conservative therapy (CTX) (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =38) versus those in patients failing CTX and receiving oral antibiotic treatment (OTX) (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =48).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods:<\/jats:title>\n                    <jats:p>We prospectively enrolled 86 breastfeeding women with breast pain lasting greater than 1 week and followed up patients through 12 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Higher initial breast (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.012) and nipple pain severity (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.004), less response to latch correction (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.015) at baseline visit, and breastmilk\n                      <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                      growth (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.001) were associated with failing CTX. Pain type was not associated with failure of CTX. When culture results were available at 5 days, breast pain remained higher (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001) in patients failing CTX and starting antibiotics. OTX patients then had more rapid breast pain reduction between 5 and 14 days (score of 3.1 vs. 1.3;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001). By 4 weeks there was no difference (1.8\/10 vs. 1.4\/10;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.088) in breast pain level between groups. Median length of OTX was 14 days. At 12 weeks, weaning frequency (17% vs. 8%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.331) was not statistically different.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Initial pain severity and limited improvement to latch correction predicts failure of CTX.\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      growth is more common in women failing CTX. For those women not responding to CTX, OTX matched to breastmilk culture may significantly decrease their pain and is not associated with increased complications.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/bfm.2013.0093","type":"journal-article","created":{"date-parts":[[2014,1,4]],"date-time":"2014-01-04T10:40:58Z","timestamp":1388832058000},"page":"63-72","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Role of Oral Antibiotics in Treatment of Breastfeeding Women with Chronic Breast Pain Who Fail Conservative Therapy"],"prefix":"10.1177","volume":"9","author":[{"given":"Ann M.","family":"Witt","sequence":"first","affiliation":[{"name":"Case Western Reserve University"},{"name":"Breastfeeding Medicine of Northeast Ohio"},{"name":"Senders Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Burgess","sequence":"additional","affiliation":[{"name":"Case Western Reserve University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas R.","family":"Hawn","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Zyzanski","sequence":"additional","affiliation":[{"name":"Case Western Reserve University"},{"name":"Case Western Reserve University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,1,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-3552"},{"key":"e_1_3_3_3_2","unstructured":"World Health Organization. Breastfeeding. www.who.int\/topics\/breastfeeding\/en\/ (accessed December18 2012)."},{"key":"e_1_3_3_4_2","unstructured":"AAFP Breastfeeding Policy Statement. 2012. www.aafp.org\/online\/en\/home\/policy\/policies\/b\/breastfeedingpolicy.html (accessed December18 2012)."},{"key":"e_1_3_3_5_2","first-page":"439","article-title":"Factors associated with weaning in the first 3 months postpartum","volume":"51","author":"Schwartz K","year":"2002","unstructured":"Schwartz K, , D'Arcy H, , Gillespie B, et al. Factors associated with weaning in the first 3 months postpartum. J Fam Pract, 2002; 51:439\u2013444.","journal-title":"J Fam Pract"},{"key":"e_1_3_3_6_2","first-page":"350","article-title":"Listening to mothers: Report of the first national US survey of women's childbearing experiences","volume":"31","author":"Declercq ER","year":"2003","unstructured":"Declercq ER, , Sakala C, , Corry MP, et al. Listening to mothers: Report of the first national US survey of women's childbearing experiences. J Perinat Med, 2003; 31:350\u2013351.","journal-title":"J Perinat Med"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-2011.2011.00136.x"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1991.tb02829.x"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000292031"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.4.e360"},{"issue":"424","key":"e_1_3_3_11_2","first-page":"e1","article-title":"The yeast connection: Is Candida linked to breastfeeding associated pain?","volume":"197","author":"Andrews JI","year":"2007","unstructured":"Andrews JI, , Fleener DK, , Messer SA, et al. The yeast connection: Is Candida linked to breastfeeding associated pain?. Am J Obstet Gynecol, 2007; 197:424. e1\u2013e4.","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_3_3_12_2","first-page":"300","article-title":"Raynaud phenomenon of the nipple in breastfeeding mothers: An underdiagnosed cause of nipple pain","volume":"149","author":"Barrett ME","year":"2013","unstructured":"Barrett ME, , Heller MM, , Fullerton Stone H, et al. Raynaud phenomenon of the nipple in breastfeeding mothers: An underdiagnosed cause of nipple pain. Arch Dermatol, 2013; 149:300\u2013306.","journal-title":"Arch Dermatol"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/0890334406293431"},{"key":"e_1_3_3_14_2","first-page":"570","article-title":"Painful nipples in nursing mothers: Fungal or staphylococal?: A preliminary study","volume":"32","author":"Graves S","year":"2003","unstructured":"Graves S, , Wright W, , Harman R, et al. Painful nipples in nursing mothers: Fungal or staphylococal?: A preliminary study. Aust Fam Physician, 2003; 32:570\u2013571.","journal-title":"Aust Fam Physician"},{"key":"e_1_3_3_15_2","first-page":"654","article-title":"Staphylococcus aureus and sore nipples","volume":"42","author":"Livingstone V","year":"1996","unstructured":"Livingstone V, , Willis C, , Berkowitz J. Staphylococcus aureus and sore nipples. Can Fam Physician, 1996; 42:654.","journal-title":"Can Fam Physician"},{"key":"e_1_3_3_16_2","first-page":"612a","article-title":"Clinical inquiries: Which interventions are best for alleviating nipple pain in nursing mothers?","volume":"58","author":"Lochner JE","year":"2009","unstructured":"Lochner JE, , Livingston CJ, , Judkins DZ. Clinical inquiries: Which interventions are best for alleviating nipple pain in nursing mothers?. J Fam Pract, 2009; 58:612a\u2013612c.","journal-title":"J Fam Pract"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/0884217505276056"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1159\/000010004"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(84)90022-X"},{"key":"e_1_3_3_20_2","unstructured":"Lactation Program University North Carolina Center for Maternal and Infant Health. UNC Culture Collection Protocol. www.mombaby.org\/PDF\/culture_protocol.2.0.pdf (accessed December2 2013)."},{"key":"e_1_3_3_21_2","unstructured":"Newman J Kernerman E. Pain Algorithm for Sore Nipples and Breasts. www.breastfeedinginc.ca\/product.php?prodID=42 (accessed December2 2013)."},{"key":"e_1_3_3_22_2","unstructured":"Health University of North Carolina Center for Maternal and Infant Health. UNC Breastfeeding Associated Pain Protocol. www.mombaby.org\/PDF\/PainProtocols.v3.pdf (accessed December2 2013)"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/000992280104000905"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/0884217504272814"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0890334404267226"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2006.0035"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2008.0144"},{"key":"e_1_3_3_28_2","unstructured":"Health University of North Carolina Center for Maternal and Infant Health. UNC Breastfeeding Associated Pain Protocol. www.mombaby.org\/PDF\/PainProtocols.v3.pdf (accessed December2 2013)."},{"key":"e_1_3_3_29_2","volume-title":"Mastitis: Causes and Management","author":"World Health Organization","year":"2000","unstructured":"World Health Organization. Mastitis: Causes and Management. Publication number WHO\/FCH\/CAH\/100.13. World Health Organization, Geneva, 2000."},{"issue":"1","key":"e_1_3_3_30_2","doi-asserted-by":"crossref","DOI":"10.1089\/bfm.2013.0012","article-title":"Bacterial species and colony count growth in breastfeeding women with chronic breast pain as compared to controls [abstract]","volume":"7","author":"Witt A","year":"2012","unstructured":"Witt A, , Mason MJ, , Burgess K, et al. Bacterial species and colony count growth in breastfeeding women with chronic breast pain as compared to controls [abstract]. Breastfeed Med, 2012; 7(Suppl 1):S-2.","journal-title":"Breastfeed Med"},{"key":"e_1_3_3_31_2","article-title":"A case control study of bacterial species and colony count in milk of breastfeeding women with chronic pain","author":"Witt A","year":"2013","unstructured":"Witt A, , Mason MJ, , Burgess K, et al. A case control study of bacterial species and colony count in milk of breastfeeding women with chronic pain. Breastfeed Med, 2013 June 21 [Epub ahead of print]. doi: 10.1089\/bfm.2013.0012.","journal-title":"Breastfeed Med"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2180-9-82"},{"key":"e_1_3_3_33_2","unstructured":"Newman J. All Purpose Nipple Ointment (APNO). https:\/\/www.nbci.ca\/index.php?option=com_content&view=article&id=76:all-purpose-nipple-ointment-apno&catid=5:information&Itemid=17 (accessed December2 2013)."},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2010.08.016"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-7-57"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1309\/WFJEBPMDHV4EAT0J"}],"container-title":["Breastfeeding Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/bfm.2013.0093","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/bfm.2013.0093","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/bfm.2013.0093","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:00:30Z","timestamp":1777381230000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/bfm.2013.0093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,1,4]]},"references-count":36,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2014,3,1]]}},"alternative-id":["10.1089\/bfm.2013.0093"],"URL":"https:\/\/doi.org\/10.1089\/bfm.2013.0093","relation":{},"ISSN":["1556-8253","1556-8342"],"issn-type":[{"value":"1556-8253","type":"print"},{"value":"1556-8342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,1,4]]}}}