Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Breastfeeding questions to medicines call centres from the Australian public and health professionals

Amelia Stephens A E , Wendy Brodribb A , Treasure McGuire B C D and Laura Deckx A
+ Author Affiliations
- Author Affiliations

A Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Health Sciences Building 16/910, Royal Brisbane & Women’s Hospital, Brisbane, Qld 4029, Australia.

B Mater Pharmacy Services, Mater Health Services, Brisbane, Qld 4101, Australia.

C School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, 20 Cornwall Street, Woolloongabba, Qld 4102, Australia.

D Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld 4229, Australia.

E Corresponding author. Email: a.stephens@uq.edu.au

Australian Journal of Primary Health 24(5) 409-416 https://doi.org/10.1071/PY18010
Submitted: 22 January 2018  Accepted: 24 April 2018   Published: 8 August 2018

Abstract

There is considerable uncertainty regarding medication use during breastfeeding. This study compared lactation-related questions about medicines from consumers and health professionals to identify knowledge gaps. A retrospective, mixed-methods study of lactation-related call data extracted from two Australian medicines call centre databases: National Prescribing Service (NPS) Medicines Line (ML) for the general public and Therapeutic Advice and Information Service (TAIS) for health professionals, was conducted. Of the 5662 lactation-related calls by consumers to ML, most were from women enquiring about themselves (95%). The 2219 lactation-related calls from health professionals to TAIS were largely from GPs (46%), community pharmacists (35%) and nurses (12%). Consumers commonly enquired about medicines freely accessible or over-the-counter, including non-steroidal anti-inflammatory products (9.3%), paracetamol (6.9%), ibuprofen (4.8%) and codeine (4.2%). Health professionals’ questions involved prescription medicines such as antidepressants (16.9%), with queries on sertraline (3.7%), levonorgestrel (2.7%) and domperidone (2.4%) most common. Question themes were similar for both cohorts, focusing mainly around medication safety, risk minimisation and milk supply. Understanding the compelling and common themes driving medicines help-seeking related to breastfeeding is key to addressing information gaps and improving overall medication use during breastfeeding.

Additional keywords: consumers, drugs, health professionals, help-seeking, lactation.


References

Akus M, Bartick M (2007) Lactation safety recommendations and reliability compared in 10 medication resources. The Annals of Pharmacotherapy 41, 1352–1360.
Lactation safety recommendations and reliability compared in 10 medication resources.Crossref | GoogleScholarGoogle Scholar |

Arguello B, Salgado TM, Fernandez-Llimos F (2015) Assessing the information in the summaries of product characteristics for the use of medicines in pregnancy and lactation. British Journal of Clinical Pharmacology 79, 537–544.
Assessing the information in the summaries of product characteristics for the use of medicines in pregnancy and lactation.Crossref | GoogleScholarGoogle Scholar |

Australian Bureau of Statistics (2008) Population distribution. (Australian Bureau of Statistics: Canberra, ACT, Australia) Available at http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Chapter3002008 [Verified 2 November 2017]

Benchimol EI, Smeeth L, Guttmann A, Harron K, Moher D, Petersen I, Sorensen H, von Elm E, Langan S, RECORD Working Committee (2015) The reporting of studies conducted using observational routinely-collected health data (RECORD) statement. PLoS Medicine 12, e1001885
The reporting of studies conducted using observational routinely-collected health data (RECORD) statement.Crossref | GoogleScholarGoogle Scholar |

Colaceci S, Giusti A, Chapin E, Notarangelo N, De Angelis A, Vellone E, Alvaro R (2015) The difficulties with antihypertensive drug prescription during lactation: is the information consistent? Breastfeeding Medicine 10, 468–473.
The difficulties with antihypertensive drug prescription during lactation: is the information consistent?Crossref | GoogleScholarGoogle Scholar |

Gendron M-P, Martin BZ, Oraichi D, Bérard A (2009) Health care providers’ requests to Teratogen Information Services on medication use during pregnancy and lactation. European Journal of Clinical Pharmacology 65, 523–531.
Health care providers’ requests to Teratogen Information Services on medication use during pregnancy and lactation.Crossref | GoogleScholarGoogle Scholar |

Hussainy SY, Dermele N (2011) Knowledge, attitudes and practices of health professionals and women towards medication use in breastfeeding: a review. International Breastfeeding Journal 6, 11–26.
Knowledge, attitudes and practices of health professionals and women towards medication use in breastfeeding: a review.Crossref | GoogleScholarGoogle Scholar |

Illamola SM, Bucci-Rechtweg C, Costantine MM, Tsilou E, Sherwin CM, Zajicek A (2018) Inclusion of pregnant and breastfeeding women in research – efforts and initiatives. British Journal of Clinical Pharmacology 84, 215–222.
Inclusion of pregnant and breastfeeding women in research – efforts and initiatives.Crossref | GoogleScholarGoogle Scholar |

Jahnsen JA, Widnes SF, Schjøtt J (2018) Analysis of questions about use of drugs in breastfeeding to Norwegian drug information centres. International Breastfeeding Journal 13, 1
Analysis of questions about use of drugs in breastfeeding to Norwegian drug information centres.Crossref | GoogleScholarGoogle Scholar |

Jayawickrama HS, Amir LH, Pirotta MV (2010) GPs’ decision-making when prescribing medicines for breastfeeding women: content analysis of a survey. BMC Research Notes 3, 82
GPs’ decision-making when prescribing medicines for breastfeeding women: content analysis of a survey.Crossref | GoogleScholarGoogle Scholar |

Lim JM, Sullivan E, Kennedy D (2009) MotherSafe: review of three years of counselling by an Australian teratology Information Service. Australian and New Zealand Journal of Obstetrics and Gynaecology 49, 168–172.
MotherSafe: review of three years of counselling by an Australian teratology Information Service.Crossref | GoogleScholarGoogle Scholar |

Mashford ML (1994) Product information: what does it define? Australian Prescriber 17, 39–41.
Product information: what does it define?Crossref | GoogleScholarGoogle Scholar |

McClatchey A, Kanaridis C, Kyle G, Cheong L, Shield A (2016) Information seeking behaviors of breastfeeding women when considering the use of over-the-counter medicines. Research in Social & Administrative Pharmacy 12, e46–e47.
Information seeking behaviors of breastfeeding women when considering the use of over-the-counter medicines.Crossref | GoogleScholarGoogle Scholar |

McDonald K, Amir LH, Davey M-A (2011) Maternal bodies and medicines: a commentary on risk and decision-making of pregnant and breastfeeding women and health professionals. BMC Public Health 11, S5
Maternal bodies and medicines: a commentary on risk and decision-making of pregnant and breastfeeding women and health professionals.Crossref | GoogleScholarGoogle Scholar |

McManus P, Mant A, Mitchell P, Britt H, Dudley J (2003) Use of antidepressants by general practitioners and psychiatrists in Australia. The Australian and New Zealand Journal of Psychiatry 37, 184–189.
Use of antidepressants by general practitioners and psychiatrists in Australia.Crossref | GoogleScholarGoogle Scholar |

National Health and Medical Research Council (2012) Eat for health: infant feeding guidelines – information for health workers. NHMRC, Canberra, ACT, Australia.

Nordeng H, Ystrom E, Einarson A (2010) Perception of risk regarding the use of medications and other exposures during pregnancy. European Journal of Clinical Pharmacology 66, 207–214.
Perception of risk regarding the use of medications and other exposures during pregnancy.Crossref | GoogleScholarGoogle Scholar |

Odom EC, Li R, Scanlon KS, Perrine CG, Grummer-Straw LM (2013) Reasons for earlier than desired cessation of breastfeeding. Pediatrics 131, e726–e732.
Reasons for earlier than desired cessation of breastfeeding.Crossref | GoogleScholarGoogle Scholar |

Rutter PM, Jones W (2012) Enquiry analysis and user opinion of the Drugs in Breastmilk Helpline: a prospective study. International Breastfeeding Journal 7,
Enquiry analysis and user opinion of the Drugs in Breastmilk Helpline: a prospective study.Crossref | GoogleScholarGoogle Scholar |

Saha MR, Ryan K, Amir LH (2015) Postpartum women’s use of medicines and breastfeeding practices: a systematic review. International Breastfeeding Journal 10, 28–37.
Postpartum women’s use of medicines and breastfeeding practices: a systematic review.Crossref | GoogleScholarGoogle Scholar |

Stephenson CP, Karanges E, McGregor IS (2013) Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011. The Australian and New Zealand Journal of Psychiatry 47, 74–87.
Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011.Crossref | GoogleScholarGoogle Scholar |

Teich AS, Barnett J, Bonuck KA (2014) Women’s perceptions of breastfeeding barriers in early postpartum period: a qualitative analysis nested in two randomized controlled trials. Breastfeeding Medicine 9, 9–15.
Women’s perceptions of breastfeeding barriers in early postpartum period: a qualitative analysis nested in two randomized controlled trials.Crossref | GoogleScholarGoogle Scholar |

Wang J, Johnson T, Sahin L, Tassinari M, Anderson P, Baker T, Bucci-Rechtweg C, Burckar G, Chambers C, Hale T, Johnson-Lyles D, Nelson R, Nguyen C, Pica-Branco D, Ren Z, Sachs H, Sauberan J, Zajicek A, Ito S, Yao L (2017) Evaluation of the safety of drugs and biological products used during lactation: workshop summary. Clinical Pharmacology and Therapeutics 101, 736–744.
Evaluation of the safety of drugs and biological products used during lactation: workshop summary.Crossref | GoogleScholarGoogle Scholar |

WHO Collaborating Centre for Drug Statistics Methodology (2016) ATC/DDD Index 2017. (WHO Collaborating Centre for Drug Statistics Methodology: Oslo, Norway) Available at http://www.whocc.no/atc_ddd_index/ [Verified 23 November 2017]

World Health Organization (2003) Introduction to drug utilisation Research. Essential medicines and health products information portal. (World Health Organisation: Geneva, Switzerland) Available at http://apps.who.int/medicinedocs/en/d/Js4876e/6.2.html [Verified 22 June 2017]