Lactation Safety Recommendations and Reliability Compared in 10 Medication Resources

Monica Akus, PharmD BCPS CACP, Melissa Bartick, MD MS

The Annals of Pharmacotherapy: Vol. 41, No. 9, pp. 1352-1360. 2007 July


BACKGROUND: Discontinuation of breast-feeding is linked with an increased risk of acute and chronic diseases in children, as well as increased risk of maternal disease. Mothers and physicians often depend on pharmacists for accurate drug information. Their information is only as good as the sources available to them.

OBJECTIVE: To determine the reliability of safety recommendations for drugs used during lactation, based on current research and information, and determine whether resources may be inappropriately advising the interruption of breast-feeding.

METHODS: A comparison of 10 frequently used sources for information on medication used during breast-feeding was done for 14 commonly used drugs. Our sources included the databases used by 2 retail pharmacy chains, available text references, and electronic references. We assessed the number of drugs thought to be safe in breast-feeding for each source. The drugs reviewed included those widely accepted as safe, widely regarded as not safe, and drugs that fit into neither category.

RESULTS: We found that many sources did consider the most recent research. For drugs thought to be unequivocally safe, the 2 retail pharmacy databases gave an alternative recommendation at least 75% of the time.

CONCLUSIONS: If healthcare practitioners are using outdated sources for making safety recommendations to their patients, such a practice may result in many women being inappropriately advised to stop breast-feeding, thus increasing the potential health risks to them and their infants. As the most accessible medication expert, the pharmacist needs to be well educated and continually updated using the most reliable resources for lactation recommendations.