Breast pain in lactating mothers.

INTRODUCTION: The number of new mothers who breastfeed has increased dramatically over the last three decades. There is a concern that the present related medical service may be inadequate. Breast pain is the most common complaint among lactating mothers who seek medical help. This study aimed to investigate this problem. METHODS: Medical records of women who presented with breast pain to a private clinic run by a doctor who was trained as an International Lactation Consultant were reviewed over a period of 6 months in 2015. Most patients were self-referred after chatting online. Assessment included characteristics and duration of pain, treatment prior to consultation, feeding practices, mother's diet, and breast examination. Any site of blockage was identified and relieved. Those with persistent pain were given antibiotics. When there were signs of abscess or abscess that could not be drained, they were referred to a breast surgeon. RESULTS: A total of 69 patients were seen of whom 45 had been breastfeeding for more than 1 month. Pain was experienced for longer than 7 days in 22 women. Antifungal or antibacterial treatment had been unsuccessful in 31 women prior to consultation. The diagnoses were engorgement in five women, blocked duct in 35, mastitis in 13, breast abscess in six, poor positioning and latch in seven, nipple cracks in two, and skin infection in one. Oral antibiotics were prescribed to 21 patients and local antifungal treatment was given to one patient only. CONCLUSION: Blocked duct was the most common cause of breast pain in lactating mothers. Without prompt relief it is possible that it will progress to mastitis/breast abscess or the mother may discontinue breastfeeding. This may be a suitable time for Hong Kong to set up one or more public full-time breastfeeding clinics to provide a better service to lactating mothers and to facilitate professional training and research.

Cardiopulmonary response to exercise of 8- and 13-year-old Chinese children in Hong Kong: results of a pilot study.

OBJECTIVES: To assess the cardiopulmonary response of healthy Hong Kong Chinese children to the treadmill test, and to identify anthropometric factors that may be related to fitness. DESIGN: Cross-sectional study. SETTING: University teaching hospital, Hong Kong. PARTICIPANTS: Forty-three 8-year-old and fifty-seven 13-year-old healthy Chinese children from middle or lower socio-economic class families in Shatin and nearby areas. MAIN OUTCOME MEASURES: The forced vital capacity, 1-second forced expiratory volume, pulse rate, and blood pressure were measured before and after undertaking the treadmill test (Bruce protocol). The endurance time until volitional exhaustion, the number of metabolic equivalents of energy used, and the sum of the skinfold thicknesses were also obtained. RESULTS: Multiple regression analysis showed that the sum of the skinfold thicknesses was positively associated with pulse rate and diastolic blood pressure at all stages of exercise, and was negatively associated with the endurance time of and number of metabolic equivalents of energy used by the 8-year-old children. The 13-year-old children had a longer cardiopulmonary endurance than the 8-year-old children. In both age-groups, pulmonary function was positively associated with height and weight. CONCLUSION: The study provides useful reference data for Hong Kong Chinese 8- and 13-year-old children when subjected to the treadmill test. A larger study is needed to establish the normal standards for children of all different ages.