Prevalence and management of breastfeeding-related breast complications among postpartum women assisted at a human milk bank in the Brazilian Amazon: a retrospective cross-sectional study

Background Breastfeeding is a cornerstone of maternal and child health, yet its continuation is frequently compromised by breastfeeding-related breast complications during the postpartum period. These conditions are a major cause of early weaning, particularly in socially vulnerable settings. This study aimed to estimate the prevalence of breastfeeding-related breast complications and to analyze factors associated with their management among postpartum women assisted by a human milk bank in the Brazilian Amazon. Methods A retrospective cross-sectional study was conducted using medical records of postpartum women attended at a Human Milk Bank in Porto Velho, Rondônia, Brazil, between January and December 2019. A total of 300 medical records were analyzed. Breast complications—including breast engorgement, mastitis, nipple fissures, and breast abscesses—were assessed as binary outcomes. Sociodemographic characteristics, exclusive breastfeeding, and non-pharmacological management strategies (breast massage, milk expression, correction of infant latch, and positioning) were evaluated as explanatory variables. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were estimated using Poisson regression with robust variance. Results Breast complications were identified in 40.3% of postpartum women, with multiple conditions often occurring in the same individual. The most prevalent conditions were nipple fissures (46.3%) and breast engorgement (40.3%), followed by mastitis (23.0%) and breast abscess (22.0%). Exclusive breastfeeding was associated with a lower prevalence of mastitis (adjusted PR = 0.27; 95% CI: 0.20–0.41) and breast abscess (adjusted PR = 0.47; 95% CI: 0.26–0.85). Non-pharmacological interventions were significantly associated with reduced prevalence of breast complications: breast massage and milk expression were protective against breast engorgement; correction of infant latch reduced nipple fissures; and correction of infant positioning showed a strong protective effect against mastitis. Conclusions Breastfeeding-related breast complications were highly prevalent among postpartum women in the Brazilian Amazon. Early, non-pharmacological interventions delivered by trained health professionals—particularly within human milk banks and primary healthcare services—were strongly associated with reduced prevalence of these conditions. These findings reinforce the importance of structured breastfeeding support to promote exclusive breastfeeding and prevent early weaning in vulnerable populations.