Drug utilization in breast-feeding women. A survey in Oslo

Abstract

In a retrospective questionnaire survey of 885 women who had given birth 3-5 months before, fewer of those who were still breast-feeding at 4 months (n = 645) were using drugs than those who had stopped breast-feeding before 4 months (n = 240), during the 2 week period preceding registration. The average number of doses (Defined Daily Doses/1000 women/day) was 166 and 307, respectively, in that period. The number of doses taken was significantly associated with the use of oral contraceptive agents (p less than 0.005) and young maternal age (p less than 0.05). Most of the variation in drug use between breast-feeding and not breast-feeding mothers was probably due to the greater use of contraception by the latter. The number of drugs used per mother in the 4 month period seemed to be best predicted by her and her infant's disorders. Long-term medication in breast-feeding women included many drugs for which there is incomplete or no data about milk transfer, e.g. salbutamol, clemastine, dexchlorpheniramine, phenylpropanolamine, cromoglycate and levomepromazine. The disorders most extensively treated with drugs in this period were dyspepsia, haemorrhoids and inflammation of the breast. The finding that smoking was associated with early weaning and consumption of alcohol with prolonged breast-feeding calls for further investigation. More information on these drug and health issues to the breast-feeding mother is highly desirable.

Drug use during breastfeeding. A survey from the Netherlands

“…Our findings of a predominant use of analgesics, vitamins, anti-infective drugs and antiaenemic preparations (iron) is very well comparable to earlier findings of a study among breastfeeding women in Norway, and several other studies on the postpartum period (Passmore et al, 1984;Matheson et al, 1990;CGDUP, 1992;Olsesen et al, 1999a,b). The fact that none of the 549 women used blood sugar lowering agents may seem surprising, but is not unlikely since the prevalence of diabetes mellitus in the Netherlands for women at the fertile age lies around 4/1000).…”

“…This view is strengthened by our findings that many breastfeeding women hesitate to use drugs, and women frequently avoid combining breastfeeding and drug use by omitting one of the two. In a study in Norway, Matheson et al (1990) found that more than half of the breastfeeding women believed that the risk of drug use during lactation was similar or higher than use of the same drugs during pregnancy. Since the opposite is trueFthe majority of drugs can be safely used during lactationFinformation about how to deal with drugs seems very important in programmes to promote breastfeeding (AAP, 2001).…”

“…The most extensive study originates from Norway, and showed that in 1985 25% of the breastfeeding mothers with children aged 3-5 months had used at least one drug in the preceding 2 weeks (Matheson et al, 1990). Several other studies described drug use in the postpartum period, but did not distinguish between breastfeeding and nonbreastfeeding women (Passmore et al, 1984;CGDUP, 1992;Olsesen et al, 1999a, b).…”

Consumo de medicamentos no período de internação para o parto

“…Foram amostrados 10,3% (424) dos partos, sendo 64,6% (274) na maternidade privada e 35,4% (150) na pública, com distribuição mensal média de 16,7% (14,(9)(10)(11)(12)(13)(14)(15)(16)(17)9). Na maternidade particular 97,1% dos partos foram pagos por seguros-saúde e 2,9% por recursos particulares.…”

“…O uso de medicamentos no parto, do momento da internação até a alta, permanece pouco investigado embora represente um momento de alto risco de consumo. [5][6][7][8][9]11 Por ser limitado no tempo, em suas possibilidades terapêuticas e por sua forte importância sócio-cultural, representa um evento privilegiado na discussão sobre a racionalidade no consumo de medicamentos, com possibilidade de intervenção pouco discutida.…”