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- Title
The use of prescription medications and non-prescription medications during lactation in a prospective Canadian cohort study.
- Authors
Soliman, Youstina; Yakandawala, Uma; Leong, Christine; Garlock, Emma S.; Brinkman, Fiona S.L.; Winsor, Geoffrey L.; Kozyrskyj, Anita L; Mandhane, Piushkumar J; Turvey, Stuart E.; Moraes, Theo J.; Subbarao, Padmaja; Nickel, Nathan C.; Thiessen, Kellie; Azad, Meghan B; Kelly, Lauren E
- Abstract
Background: A lack of safety data on postpartum medication use presents a potential barrier to breastfeeding and may result in infant exposure to medications in breastmilk. The type and extent of medication use by lactating women requires investigation. Methods: Data were collected from the CHILD Cohort Study which enrolled pregnant women across Canada between 2008 and 2012. Participants completed questionnaires regarding medications and non-prescription medications used and breastfeeding status at 3, 6 and 12 months postpartum. Medications, along with self-reported reasons for medication use, were categorized by ontologies [hierarchical controlled vocabulary] as part of a large-scale curation effort to enable more robust investigations of reasons for medication use. Results: A total of 3542 mother-infant dyads were recruited to the CHILD study. Breastfeeding rates were 87.4%, 75.3%, 45.5% at 3, 6 and 12 months respectively. About 40% of women who were breastfeeding at 3 months used at least one prescription medication during the first three months postpartum; this proportion decreased over time to 29.5% % at 6 months and 32.8% at 12 months. The most commonly used prescription medication by breastfeeding women was domperidone at 3 months (9.0%, n = 229/2540) and 6 months (5.6%, n = 109/1948), and norethisterone at 12 months (4.1%, n = 48/1180). The vast majority of domperidone use by breastfeeding women (97.3%) was for lactation purposes which is off-label (signifying unapproved use of an approved medication). Non-prescription medications were more often used among breastfeeding than non-breastfeeding women (67.6% versus 48.9% at 3 months, p < 0.0001), The most commonly used non-prescription medications were multivitamins and Vitamin D at 3, 6 and 12 months postpartum. Conclusions: In Canada, medication use is common postpartum; 40% of breastfeeding women use prescription medications in the first 3 months postpartum. A diverse range of medications were used, with many women taking more than one prescription and non-prescription medicines. The most commonly used prescription medication by breastfeeding women were domperidone for off-label lactation support, signalling a need for more data on the efficacy of domperidone for this indication. This data should inform research priorities and communication strategies developed to optimize care during lactation.
- Subjects
CANADA; STEROID drugs; VITAMIN therapy; SELF-evaluation; BREASTFEEDING; PATIENT safety; RESEARCH funding; CHILD health services; QUESTIONNAIRES; PIPERIDINE; DESCRIPTIVE statistics; LACTATION; LONGITUDINAL method; DRUGS; ONTOLOGIES (Information retrieval); NONPRESCRIPTION drugs
- Publication
International Breastfeeding Journal, 2024, Vol 19, Issue 1, p1
- ISSN
1746-4358
- Publication type
Article
- DOI
10.1186/s13006-024-00628-x