Association of postpartum medication practices with early breastfeeding cessation among mothers with chronic conditions: A prospective cohort study

Abstract

Introduction Use of medications is a common concern for breastfeeding women, particularly when they are strongly needed or unavoidable to manage maternal chronic conditions. Yet the influence of medication usage patterns on breastfeeding duration in mothers with chronic conditions is unclear. The objective of this study was to examine whether postpartum medication practices were associated with shorter breastfeeding duration or earlier than planned breastfeeding cessation among mothers with chronic conditions. Material and methods We analyzed 346 mothers with chronic conditions enrolled in a prospective, community‐based pregnancy cohort study (Alberta, Canada) who initiated breastfeeding after birth. Data were collected through self‐report questionnaires spanning late pregnancy to 6 months postpartum. Based on reported use of preexisting medications while breastfeeding, women were classified as continuing medications (reference group), discontinuing one or more medications, or those who did not use preexisting medications. Cox proportional hazards regression was used to analyze the association of medication practices and overall breastfeeding duration in weeks. Logistic regression was used to analyze the association of medication practices and earlier than planned breastfeeding cessation. Multivariable models adjusted for demographic and health‐related factors. Results Overall, 30.6% of women with chronic conditions stopped breastfeeding in the first 6 months, almost all of whom did so earlier than planned. In multivariable models, medication discontinuation was significantly associated with shorter breastfeeding duration (adjusted hazard ratio [HR] 1.67, 95% confidence interval [CI] 1.03–2.70) and earlier than planned breastfeeding cessation (adjusted odds ratio [OR] 1.85, 95% CI 1.01–3.42), whereas medication non‐use was not associated with differences in breastfeeding outcomes. Conclusions Women with chronic conditions who discontinued preexisting medications while breastfeeding had significantly shorter breastfeeding duration and were less likely to meet their breastfeeding goals in the first 6 months postpartum compared to women who continued preexisting medications.

Medication Intake as a Factor for Non-Initiation and Cessation of Breastfeeding: A Prospective Cohort Study in Greece during the COVID-19 Pandemic

“…Lactating women with a pre-existing chronic condition have a higher likelihood of medication use during lactation [ 16 ]. A very recent study conducted in Canada concluded that breastfeeding duration was significantly shorter for chronically ill women who discontinued their medications while breastfeeding, and their breastfeeding goals were less likely to be accomplished compared to women who continued to take their medicines [ 32 ]. Thus, future studies should particularly examine the impact of medication use due to chronic diseases on breastfeeding initiation, duration and cessation.…”