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Lactational Mastitis: Evidence for Probiotic Therapy

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Danny Urbinder ● 2 min read

Mastitis is a common infectious disease affecting women during lactation. It is now believed to be linked with dysbiosis and applying probiotic therapy is proving to be a safe and effective alternative to antibiotics.

In one study,[1] the efficacy of oral administration of Lactobaccilus fermentum or L. salivarius to treat lactational mastitis was evaluated and compared to that of antibiotic therapy.

A total of 352 women with infectious mastitis were randomly assigned to three groups. Women in group A and B ingested either 1 billion CFU of L. fermentum or L. salivarius daily for three weeks. Those in group C received antibiotics as prescribed in their respective primary care centres.

On day 0, the mean bacterial counts in milk samples of the three groups were similar and lactobacilli could not be detected. On day 21, the mean infective bacteria counts in the probiotic groups were lower than that of the control group. 

L. fermentum and L. salivarius were isolated from the milk samples of women in the probiotic groups A and B. Women assigned to the probiotic groups showed greater improvement and had lower recurrence of mastitis than those assigned to the antibiotic group. The use of L. fermentum or L. salivarius appears to be effective for the treatment of infectious mastitis.

In another study,[2] 20 women with staphylococcal mastitis were randomly divided in two groups. Those in the probiotic group ingested 10 billion CFU of L. salivarius and the same quantity of L. gasseri daily for four weeks, while those in the control group had a placebo. The probiotic strains were originally isolated from the breast milk of healthy women.

On day 0, the mean staphylococcal counts in the two groups were similar and lactobacilli could not be detected. 

On day 30, the mean staphylococcal count in the probiotic group was lower than that of the control group. L. salivarius and L. gasseri were isolated from the milk samples of six out of ten women in the probiotic group. 

At day 14, no clinical signs of mastitis were observed in those in the probiotic group, but mastitis persisted throughout the study period in the control group women. The researchers concluded that L. salivarius and L. gasseri appear to be efficient for the treatment of lactational infectious mastitis.

Practice Points

Probiotics have been shown confer many benefits both in pregnancy and post-partum. Improved immunity, reductions in atopy and allergy and now, it’s showing to be a great supportive therapy for both the treatment and the prevention of lactational mastitis. Given that mastitis can be a key driver in women abandoning breastfeeding, due to the pain and complications, implementing probiotics as part or perinatal care could be a catalyst in not only preventing infection, but helping new mother’s maintain their breastfeeding for long than may have otherwise occurred. 


  1. Arroyo R, Martin V, Maldonado A, et al. Treatment of infectious mastitis during lactation: antibiotics versus oral administration of lactobacilli Isolated from breast milk. Clin Infect Dis 2010;50(12):1551-1558. [Full Text]
  2. Jimenez E, Fernandez L, Maldonado A, et al. Oral administration of lactobacillus strains isolated from breast milk as an alternative for the treatment of infectious mastitis during lactation. Appl Envir Microbiol 2008;8;4650-4655. [Full Text]


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