Where can we find data that links infant outcomes, breastfeeding and medicine exposure? A new systematic scoping review from ConcePTION shows that the information that is available is not enough. And calls for action to provide long term population-based data and to monitor infants for adverse effects.
Information on the impact of medicines on breastfeeding rates and the health of breastfed infants remains scarce. Researchers from Swansea University led the work on a systematic scoping review just published in PLOS ONE, aiming to identify existing databases and cohorts with information, in this field where information and evidence are scarce.
Professor Sue Jordan from Swansea University’s Faculty of Medicine, Health and Life Science, led the research. She indicated that some of the existing resources, such as LactMed, are excellent. But despite thorough searches, they often have little information to offer and report only small case series. This puts new mothers and their babies in a difficult position when it comes to decisions about medicines – that the mother needs – and breastfeeding, which has health benefits for both mother and baby. Sue Jordan said:
“No sections of the population should be excluded from the protection afforded by timely collection and analysis of data on the safety of medicinal products. However, the omission of breastfeeding data from most population databases indicates that there are few data to inform breastfeeding patients and those intending to breastfeed”.
In the paper, the authors ask the research community and health authorities to action this problem, and provide long-term population-based data on any adverse events in infants exposed to medicines through breastmilk.
We also need more data on whether the need for treatment or the medicines themselves lead to any reductions in breastfeeding rates. And, the authors emphasise, that in order to ensure that the impact of ‘not breastfeeding’ is captured, long-term data needs to include educational outcomes for the child.
More data are needed on newborns. Authors call for infants to be monitored for any possible adverse drug reactions from exposure to medicines through breastmilk, even if problems can be rare, subtle and easily overlooked. If the mother needs medicines to treat mental health conditions, we should observe the infant for sleepiness, drowsiness and sedation. We should also weigh and chart sleep more closely than is done in the standard psychical assessments, which, in the UK, are done at 72 hours and 6 weeks.
New mothers are a vulnerable group, and some struggle with breastfeeding. Knowledge about medicines that could make breastfeeding more difficult, or complicate the decision to breastfeed, requires us to provide more support to these patients, and address any fears of unknown adverse effects of medicines on their child.
Read the paper: Where are the data linking infant outcomes, breastfeeding and medicine exposure? A systematic scoping review
Cite as: Jordan S, Komninou S, Lopez Leon S (2023) Where are the data linking infant outcomes, breastfeeding and medicine exposure? A systematic scoping review. PLOS ONE 18(4): e0284128. https://doi.org/10.1371/journal.pone.0284128
Want to know more? Read the press-release from Swansea University: Action needed on breastfeeding data collection to gauge medicine impact
By Josepine Fernow