Breastfeeding questions to medicines call centres from the Australian public and health professionals

Abstract

There is considerable uncertainty regarding medication use during breastfeeding. This study compared lactation-related questions about medicines from consumers and health professionals to identify knowledge gaps. A retrospective, mixed-methods study of lactation-related call data extracted from two Australian medicines call centre databases: National Prescribing Service (NPS) Medicines Line (ML) for the general public and Therapeutic Advice and Information Service (TAIS) for health professionals, was conducted. Of the 5662 lactation-related calls by consumers to ML, most were from women enquiring about themselves (95%). The 2219 lactation-related calls from health professionals to TAIS were largely from GPs (46%), community pharmacists (35%) and nurses (12%). Consumers commonly enquired about medicines freely accessible or over-the-counter, including non-steroidal anti-inflammatory products (9.3%), paracetamol (6.9%), ibuprofen (4.8%) and codeine (4.2%). Health professionals' questions involved prescription medicines such as antidepressants (16.9%), with queries on sertraline (3.7%), levonorgestrel (2.7%) and domperidone (2.4%) most common. Question themes were similar for both cohorts, focusing mainly around medication safety, risk minimisation and milk supply. Understanding the compelling and common themes driving medicines help-seeking related to breastfeeding is key to addressing information gaps and improving overall medication use during breastfeeding.

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

“…6 Faced with inadequate information and counseling, 1 mothers often struggle with decisions about medications and breastfeeding, and internalize the beliefs that medications are harmful to the breastfed child and should be avoided altogether. [7][8][9][10] Maternal illness and need to take medications are among the frequent reasons for early breastfeeding cessation and are associated with lower likelihood of mothers meeting their breastfeeding goals. 11 Decisions about medication use and breastfeeding are particularly relevant for the 10%-20% of mothers who live with a chronic condition, [12][13][14] most of whom require medication use to manage symptoms and maintain quality of life.…”

“…While most medications have been deemed safe for use during breastfeeding on the basis of low transfer into breast milk, 4,5 healthcare providers’ knowledge of and confidence in forming recommendations for medication use in breastfeeding patients is variable, generally erring on the side of caution 6 . Faced with inadequate information and counseling, 1 mothers often struggle with decisions about medications and breastfeeding, and internalize the beliefs that medications are harmful to the breastfed child and should be avoided altogether 7–10 . Maternal illness and need to take medications are among the frequent reasons for early breastfeeding cessation and are associated with lower likelihood of mothers meeting their breastfeeding goals 11 …”

Development and Pilot Use of a Questionnaire to Assess the Knowledge of Midwives and Pediatric Nurses on Maternal Use of Analgesics during Lactation

“…Currently, acetaminophen is considered to be the most commonly used medicine in the pregnant and breastfeeding population [ 10 , 11 , 12 , 13 ]. Midwives and pediatric nurses come across breastfeeding mothers on a daily base and play a crucial role in educating and informing them on the use of analgesics during lactation [ 11 ]. The level of knowledge and the potential differences in the level of knowledge between midwives and pediatric nurses on this topic are generally unknown, including for Belgium, but is anticipated to be different based on their specific curricula.…”

Development of a Questionnaire and Pilot Use to Assess the Knowledge of Midwives and Pediatric Nurses on Maternal Use of Analgesics during Lactation

“…This includes acetaminophen (paracetamol), aspirin and non-steroidal anti-inflammatory drugs (NSAIDs). Currently, acetaminophen is considered to be the most commonly used medicine in the pregnant and breastfeeding population [10][11][12][13]. Midwives and pediatric nurses come across breastfeeding mothers on a daily base and play a crucial role in educating and informing them on the use of analgesics during lactation [11].…”

“…Currently, acetaminophen is considered to be the most commonly used medicine in the pregnant and breastfeeding population [10][11][12][13]. Midwives and pediatric nurses come across breastfeeding mothers on a daily base and play a crucial role in educating and informing them on the use of analgesics during lactation [11]. The level of knowledge and the potential differences in the level of knowledge between midwives and pediatric nurses on this topic is generally unknown, including for Belgium, but is anticipated to be different based on their specific curricula.…”