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

Abstract

Pharmacological treatment may become a barrier for a mother’s breastfeeding goals. We aimed to investigate maternal medication intake as a factor for non-initiation and cessation of breastfeeding and the effect of professional counseling on maternal decision-making. Throughout 2020,847 women were recruited from five healthcare institutions. Information was gathered prospectively with an organized questionnaire through interview during hospitalization and through telephone at 1, 3 and 6 months postpartum. Results revealed that from the 57 cases of breastfeeding cessation due to medication intake, only 10.5%received evidence-based counseling from a physician. Unfortunately, 68.4% (n = 39/57) of the participants ceased breastfeeding due to erroneous professional advice. The compatibility of medicines with breastfeeding was examined according to the Lactmed and Hale classification systems, which showed discrepancy in 8 out of 114 medicines used, while 17.5% and 13.2% of the medicines, respectively, were not classified. Educational level, employment at six months postpartum, mode of delivery, previous breastfeeding experience, medication intake for chronic diseases, physician’s recommendation and smoking before pregnancy were factors significantly correlated with breastfeeding discontinuation due to medication intake. The COVID-19 restrictions protected women from ceasing breastfeeding due to medication intake. Maternal and lactation consultancy should be strictly related to evidence-based approaches.

Counseling by midwives on medication intake during a woman’s reproductive life

“…respiratory infection, pre-eclampsia), breastfeeding, or at any stage of a woman's life.Occasionally, women receive conflicting advice from healthcare professionals that is not based on evidence-based knowledge, leading them to wean unnecessarily (Hanley et al, 2020, Saha et al, 2015. In a recent study regarding the effect of medication use on breastfeeding initiation and discontinuation conducted in Greece, of all women who discontinued breastfeeding due to medication intake (14.4%, n=57/397), 68.4% of them were led to weaning due to incorrect advice from healthcare professionals (obstetricians, paediatricians, physicians of other specializations) (Tigka et al, 2023). Although various sources of information are reliable on the compatibility of medications with breastfeeding (Hale, 2021, Lactmed, 2006, it was reported that the physicians who counseled mothers had not relied on evidence-based knowledge.…”