News article

Study shows that most breastfeeding medication resources are inaccurate

July 25, 2007

(Cambridge) Pharmacies give mothers inaccurate advice when it comes to medication safety in breastfeeding, according to a new study in the Annals of Pharmacotherapy.

The study’s authors examined the safety information used by two large retail pharmacy chains on the East Coast, looking at 14 commonly-prescribed medications. For 75 percent of drugs that are considered unequivocally safe for breastfeeding, pharmacies were inappropriately advising mothers to stop nursing.

“We were surprised by the results, when we looked at all the resources systematically,” said lead author, Monica Akus, PharmD, a pharmacist at Cambridge Health Alliance and Assistant Professor of Pharmacy at University of Rhode Island. Several well-respected sources used out of date information, most commonly resulting in inappropriate advice to stop breastfeeding. “As pharmacists, our training in drugs and lactation is often limited, so it’s critical to spread the word to other pharmacists. Our knowledge is only as good as our resources,” notes Akus.

The study compared the assessments of ten commonly used resources for medication information, including resources used by pharmacists and physicians.

The authors found that the most reliable resource at this time is LactMed, a free online resource from the National Library of Medicine, which was introduced in the spring of 2006. This resource used the most complete and up-to-date research, and was closely followed by the 2006 print edition of Thomas Hale’s Medications and Mothers Milk.

The authors highlighted the public health aspect of breastfeeding, and the increased risk to maternal and child health when breastfeeding is discontinued earlier than medically recommended. “In essence, medication advice becomes a risk management issue and a quality issue,” said Melissa Bartick, MD, the study’s other author and the current chair of the Massachusetts Breastfeeding Coalition.

“Often pharmacists and clinicians mistakenly think that if one doesn’t know the safety information for a drug, it is safest to advise the patient to stop breastfeeding. Clinicians and pharmacists need to appreciate that such advice may carry serious health risks, too, often much worse than the risk of taking a drug,” Fortunately, it’s now easy for any pharmacist to look up accurate information on a medication. “All you need is internet access,” says Bartick, an internist. Most retail pharmacies have access to the internet, says Akus.

The study is published electronically ahead of print, which will appear in the September 2007 issue. The abstract is available here.