Shared decision-making about medication intake during lactation: A prospective longitudinal study in Greece

Abstract

INTRODUCTION The need for medication intake during lactation may affect women’s decision on breastfeeding initiation, duration or cessation. We investigated shared decision-making about medication intake (MI) during lactation by breastfeeding women. METHODS The study was conducted in five maternity hospitals in Greece (January–August 2020). A total of 283 mothers participated in the study. Data were obtained through a self-designed questionnaire. Mothers answered the questionnaire before discharge and were followed up by phone interviewing at one, three and six months postpartum. Information about breastfeeding status, reasons for cessation and MI during lactation were gathered. RESULTS In total, 30.7% of the mothers were receiving medication due to a pre-pregnancy chronic condition but only 23.7% maintained it during lactation; 48.4% of mothers stated that they would avoid MI during lactation as a personal attitude and 45.2% were satisfied with the information provided by healthcare professionals (HPs) concerning MI during lactation. But, 66.1% of the mothers indicated the necessity of further guidance. Mothers with higher education, Greek ethnicity and vaginal delivery participated significantly in the decision-making process concerning MI during lactation (p=0.001, p=0.001 and p=0.01, respectively). Mothers who shared decision-making, primarily consulted a pediatrician (p=0.02) and were more likely to maintain full and mixed breastfeeding for one month postpartum, rather than cease breastfeeding (p=0.005). Breastfeeding duration of all indicators was for a mean of 110 days (SD: 74.58). CONCLUSIONS Advancing HPs’ evidence-based knowledge, communication skills, confidence and competence in breastfeeding management will contribute favorably to breastfeeding indicators and maternal satisfaction regarding professional counseling.

Maternal tobacco, alcohol and caffeine consumption during the perinatal period: A prospective cohort study in Greece in the midst of COVID-19 pandemic

“…The present study is part of a broader research protocol on addictive substances and medication intake during lactation 13 . It is a prospective cohort study conducted during the COVID-19 pandemic and specifically between January and August 2020.…”

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

“…In such scenarios, the decision-making process for medication use during lactation should be on the basis of healthcare professionals’ (HPs) current knowledge and expertise in providing information hinged on scientific research about the breastfeeding benefits and the drug exposure risks via breast milk for the nursing child [ 1 ]. Since the majority of medicines have not been linked to adverse effects when used during lactation, and that even a temporary interruption of breastfeeding can create difficulties for the mother–child dyad, lactating women should be enlightened about reliable resources which refer to medicines during lactation and, finally, supported to share decision-making with their physician [ 2 , 3 ].…”

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

“…in supporting lactation includes providing counselling on the compatibility of medications with breastfeeding and encouraging the shared decision-making process (Tigka et al, 2022, Al-Sawalha et al, 2016.…”