Midwives' knowledge and diagnostic practices for mastitis and breast cancer in breastfeeding women in Japan: A cross-sectional study.

Abstract

Introduction: Japanese midwives support lactating women to continue breastfeeding. However, midwives often learn breast care methods through practical experience. This study investigated how midwives acquire knowledge about mastitis and breast cancer.

Methods: This cross-sectional study was conducted in Japan over two months. The study participants were midwives with breast care experience. The questionnaire was sent to 800 midwifery facilities for recruitment. The questions covered learning and diagnostic methods for general breast care, bacterial mastitis, severe mastitis, and breast cancer during lactation. The analysis method involved descriptive statistics. An Ethical Review Committee approved this study.

Results: The survey return rate was 27.50% (n=200). The valid response rate was 87.27% (n=192). Although the learning method that helped midwives most regarding mastitis, in general, was breast care experience (38.0%), knowledge about bacterial mastitis and severe mastitis came from advice from doctors or senior midwives (33.3%, 42.4%). However, knowledge about breast cancer during lactation was mostly learned during formal education (29.5%); many had never learned about it (10.5%). The most common method used by midwives to make breast care decisions was subjective judgment.

Conclusions: Most midwives learned a great deal by observing and palpating actual breasts in clinical settings. Some midwives had learned very little about breast cancer. Most midwives did not use medical equipment for breast evaluations. This suggests that Japanese midwives have high breast care skills. However, there is room for improving midwives' skills in using medical equipment.