The Identifying and Counseling of Breastfeeding Women by Pharmacists

Abstract

Pharmacists need a consistent approach to identify breastfeeding women and access to reliable, continuously updated resources to guide their advice about medication use to breastfeeding women. Physicians and pharmacists should collaborate to prevent medication use from being a barrier to breastfeeding.

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

“…Table 1 details 11 studies - seven that have been conducted with health professionals only [17,18,21,26,28,31,32] (where references 17-18 and 21 concern the same study); two with pharmacists, general practitioners (GPs) and breastfeeding women together [22,23] (these concern the same study); another with pharmacists and breastfeeding women [25]; and one with endocrinologists, family physicians and women [30]. In the four studies that involved health professionals and women [22,23,25,30], only the findings on the health professionals have been detailed, and those associated with the women are shown in Table 2.…”

“…Ronai et al found that 58% of pharmacists surveyed never asked women if they were breastfeeding [26]; however, this study was carried out with a small sample of participants. While Jones and Brown reported that 50% of pharmacists said they would ask a woman with a baby how she was feeding before prescribing an over-the-counter (OTC) medication (available without prescription) for her, many pharmacists stated that it was the responsibility of the woman to inform them that she was breastfeeding when purchasing a medication, with two pharmacists commenting that questions of this nature are too personal and cannot be asked in the pharmacy environment [23].…”

“…However, despite their self-reported confidence, in a postal survey of GPs in Victoria, respondents had concerns about medico-legal issues: 76% of GPs rated the possible risk of litigation as "important/very important" [18]. Similarly, it has been found that some pharmacists feel comfortable advising breastfeeding women and are cautious with their recommendations to them [26]. In this study by Ronai et al, pharmacists believed that it is better to stop breastfeeding than risk exposing an infant to a potentially harmful medication [26].…”

“…Similarly, it has been found that some pharmacists feel comfortable advising breastfeeding women and are cautious with their recommendations to them [26]. In this study by Ronai et al, pharmacists believed that it is better to stop breastfeeding than risk exposing an infant to a potentially harmful medication [26]. They also commented that there are contradictory and inconsistent resources available on medication use in lactation, as have GPs who have also indicated the need for a reliable internet database (that includes information on complementary medicines), or information via their software prescribing program, [17,18,21] instead of having to rely on pharmaceutical companies for drug information that is usually "over cautious" [21].…”

African-American and Latina Women Seeking Public Health Services: Cultural Beliefs regarding Pregnancy, including Medication-taking Behavior

“…"The commonality among these services is the ability of the pharmacist to provide them and the direct interaction between the pharmacist and the patient 1 ." In the area of women's reproductive health pharmacists have important roles, including providing counseling for oral contraceptives, assessing the effects that changes in maternal physiology during pregnancy may have on the pharmacokinetics of chronic medications, and identifying pregnancy or lactation-contraindicated drugs and [2][3][4] . Pharmacists are now able to directly dispense emergency contraception in several states [5][6] .…”