Knowledge, attitudes and practices of health professionals and women towards medication use in breastfeeding: A review

Abstract

Many breastfeeding women require and regularly take medicines, especially those available over-the-counter, and the safe use of these is dependent on the advice provided by health professionals such as general practitioners and pharmacists. The primary aim of this review therefore, was to investigate the literature relating to health professionals' and women's knowledge, attitudes and practices towards medication use and safety in breastfeeding. The limited literature that was uncovered identified that general practitioners and pharmacists have poor knowledge, but positive attitudes, and variable practices that are mostly guided by personal experience. They tend to make decisions about the use of a medicine whilst breastfeeding based on the potential 'risk' that it poses to the infant in terms of possible adverse reactions, rather than its 'compatibility' with breast milk. The decision-making process between health professionals and women is usually not a negotiated process, and women are often asked to stop breastfeeding whilst taking a medicine. Women, in turn, are left dissatisfied with the advice received, many choosing not to initiate therapy or not to continue breastfeeding. Some directions for future research have been suggested to address the issues identified in this critical area. This review is important from a societal perspective because many breastfeeding women require and regularly take medications, especially those available without prescription, and the safe use of these is dependent on the advice provided by health professionals, which is ultimately influenced by their knowledge, attitudes and practices. However, there is an absence of high quality evidence from randomised controlled trials on the safety of medications taken during breastfeeding, which naturally would hinder health professionals from appropriately advising women. It is equally important to know about women's experiences of advice received from health professionals, and whether there is consistency between recommendations made across resources on medication safety in breastfeeding, in order to gain a full understanding of the issues prevalent in this area of practice.

Perspectives and attitudes of breastfeeding women using herbal galactagogues during breastfeeding: a qualitative study

“…Consistent with the literature and previous findings, breastfeeding women identified the need for more in-depth information, including scientific evaluation of the efficacy and safety of herbal galactagogues and other herbal medicines during breastfeeding [22,28,33]. Women expect health professionals to have adequate knowledge and to be willing to offer advice and discussion over alternative therapies to promote breastfeeding performance.…”

Breastfeeding friendly pharmacies: a setting with potential

“…Many women cease breastfeeding unnecessarily due to fear of harm from drugs being excreted into breastmilk, and pharmacists may contribute to the misconception about this risk 2–4 . Further, qualitative data from Australia suggests pharmacy staff most commonly respond to breastfeeding difficulties with advice about infant formula, rather than breastfeeding perseverance 5 .…”

Lactantes em tratamento medicamentoso da rede pública de saúde

“…Após o parto, o uso de medicamentos é frequente entre as lactantes, devido à necessidade de tratamento para combater infecções, depressão, além das doenças crônicas que requerem medicamentos de uso contínuo (4)(5)(6) . Sabe-se que mais de 50% das mulheres que estão amamentando usam algum tipo de medicamento (7,8) . Geralmente, a concentração do fármaco que alcança o leite materno é reduzida, apresentando baixa relevância para o lactente (9) .…”