Complementary medicines in pregnancy: recommendations and information sources of healthcare professionals in Australia

Abstract

Background The use of oral complementary and alternative medicines, including herbal supplements, has been increasing in pregnant women worldwide despite limited safety data. The decision of healthcare professionals to recommend these products to pregnant patients is controversial and not well documented. Objective To explore the recommendations and information sources that healthcare professionals use to determine the safety of oral non-prescribed supplements during pregnancy. Setting An Australian metropolitan maternity hospital. Method An electronic survey was distributed to doctors, midwives, pharmacists, dietitians, lactation consultants and physiotherapists. Main outcome measure The nature of recommendations and information sources that healthcare professionals use to determine the safety of oral non-prescribed supplements during pregnancy. Results Responses were received from 54 healthcare professionals. Forty of 54 (74.1%) were concerned about the safety of their patients' supplements, while 35 of 54 (64.8%) felt that they had access to trustworthy safety information. Supplements most commonly recommended as safe to use were ginger (40.7%), probiotics (29.6%) and raspberry leaf (22.2%). Participants specifically requested further safety information for raspberry leaf, evening primrose oil, fish oil, probiotics, ginger, vitamin C, valerian, turmeric, blue cohosh and colloidal silver. Written resources most frequently consulted included MIMS (61.1%) and 'Google Searches' (29.6%), and healthcare professionals most referred to were pharmacists (74.1%), doctors (22.2%), and naturopaths or herbalists (3.7%). Conclusion The recommendations of maternity heath care professionals and quality of information sources used varied. Further education and access to unbiased safety information is required to empower healthcare professionals to provide informed recommendations to pregnant patients.

Medication Use During Pregnancy and Lactation in a Dutch Population

“…Moreover, until now, most probiotics have been registered as food supplements, not as medication; therefore, they did not have to fulfill the legal and/or efficacy criteria. Recently, Gilmartin, Vo-Tran, and Leung (2018) concluded that the available safety data of probiotics can be considered neither alarming nor having the robustness to suggest an absolute recommendation as safe during pregnancy. Safety depends on the strains within the products used, usually being one or more varieties of bifidobacterium, lactobacillus, saccharomyces , and streptococcus thermophiles .…”

“…Safety depends on the strains within the products used, usually being one or more varieties of bifidobacterium, lactobacillus, saccharomyces , and streptococcus thermophiles . Especially for the latter two strains, no safety evidence is available (Gilmartin et al, 2018).…”

“…In general, little is known about their safety. Given that homeopathic medicines sometimes contain pharmacologically active ingredients, caution is needed when it comes to the use of these remedies during pregnancy and lactation (Dante, Bellei, Neri, & Facchinetti, 2014; Gilmartin et al, 2018).…”

Utilisation of a NSW teratology information service by pharmacists and patients referred by a pharmacist from 2000 to 2018

“…Complementary medicine use in pregnancy is well documented in the literature (although pregnancy safety data are extremely limited) with perceived benefits cited by women including ‘natural products’, self‐determination and belief in a holistic approach . Not surprisingly Australian health professionals are uncertain about the safety of complementary medicines in pregnancy and how to source or provide appropriate information …”

Women’s Consumption of Probiotic Food; The Example of Yogurt and Kefir

“…The scholarly literature reported that the rate of constipation during pregnancy ranged from about 11% to 38% (28). However, there are many studies proving that probiotics prevent constipation, a problem frequently encountered during pregnancy (29)(30)(31) Looking at the "Factors Affecting Women's Consumption of Probiotic Foods", the influence of health personnel on consumption of probiotics was minor (9.8%) ( Table 2). The study by Zeren (2015) emphasized that advertisements were the most influential factor that affect adults' consumption of probiotics (17).…”