Postpartum depression is surprisingly common, affecting some 10-15% of new mothers. Antidepressants are often prescribed, which raises questions about how safe it is to breastfeed while undergoing medical treatment. This is of course a concern for parents, who want to know if their baby will suffer any adverse effects. But nurses, midwives, pharmacists and doctors rarely have the evidence needed to help women make an informed choice between breast and bottle. An editorial in the Pharmaceutical journal raises this and other questions that parents often do not ask, but where health care professionals could provide both answers and support to parents.
When the mother needs medicines, families often ask if particular medicines are compatible with breastfeeding, and if their breastfed baby might suffer from adverse side effects. But they rarely ask the doctor if a medicine could make breastfeeding more difficult. In fact, there is evidence that some medicines have that effect, particularly antidepressants. This paper discusses the information gap, and what parents want to know, versus what professionals have evidence to tell them. According to Sue Jordan, Professor of Medicines Management and Health Services’ research at Swansea University, there are things we can do to support families. There is some evidence that some medicines affect the ability to breastfeed, but this is not a question that women tend to ask.
“We know that antidepressants can have this effect, and many new mothers suffer from depression. There is sufficient evidence to indicate that additional support is warranted for these women”, says Sue Jordan.
Another question that is rarely asked is what signs and symptoms to be vigilant about if the mother is using a medicine. By providing information, health care professionals can help parents understand the signs that a baby could have been over-exposed to medicines via breastmilk. But informing is not enough. Health care providers also need to be vigilant, monitor and report exposure to medicines, and any signs that babies experience adverse effects, in both long and short term.
“There are no structured monitoring protocols are available, but these should be developed, tested and administered to these vulnerable dyads of mother-and-baby”, says Sue Jordan.
The editorial was published in Pharmaceutical Journal, and builds on work published earlier this year in the International Breastfeeding Journal, where ConcePTION researchers concluded that we are looking at a veritable information desert. In that paper, authors recommend that population databases should link data medicine exposure, breastfeeding and infant development, and note that only very few European population databases do this today.
Read the editorial: Jordan S, Jones E, Komninou S, Loane M & Damase-Michel C, Families need support to reduce the risk of adverse drug reactions from breastfeeding, Pharmaceutical Journal, 7 November 2022
More information in: Jordan, S., Bromley, R., Damase-Michel, C., Given, J., Komninou, S., Loane, M., Marfell, N., & Dolk, H. (2022). Breastfeeding, pregnancy, medicines, neurodevelopment, and population databases: the information desert. International Breastfeeding Journal, vol 17(55). https://doi.org/10.1186/s13006-022-00494-5
By Josepine Fernow