School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
MotherSafe, The Royal Hospital for Women, Sydney, New South Wales, Australia.
Breastfeed Med. 2019 Nov;14(9):674-679. doi: 10.1089/bfm.2019.0010. Epub 2019 Aug 1.
MotherSafe is a free telephone-based counseling service for Australian consumers and health care providers concerned about drug exposures during pregnancy and breastfeeding. Calls relating to breastfeeding are relatively common and a source of significant distress to the breastfeeding mother, particularly if there is a lack of clarity regarding possible adverse effects of drug exposure on the infant. This study seeks to identify the medication exposures of concern for breastfeeding mothers and the information available to address these concerns. To review calls to MotherSafe about breastfeeding drug exposures during the 19-year period from 2000 to 2018 and to highlight drugs of concern and counseling issues. A retrospective descriptive assessment of a prospectively collected Access database was undertaken. Phone counseling records identified the medication (and other) exposures of concern regarding breastfeeding. The information about medication exposures via breastfeeding provided in consumer and product information (PI) was also reviewed. Of a total of 315,158 calls received at MotherSafe between 2000 and 2018, 116,876 (37.1%) were regarding drug exposure via breastfeeding; 30% of these calls related to nonsteroidal anti-inflammatory drugs, antihistamines, antidepressants, simple analgesics, and antibiotics, and 5% were regarding an exposure specifically contraindicated when breastfeeding. Queries about medication exposures via breastfeeding represent a significant proportion of all the counseling calls to MotherSafe. This study demonstrates the inconsistent and often misleading information about breastfeeding exposures found in consumer and PI sheets and online and highlights the important role of Teratogen Information Services like MotherSafe in providing evidence-based information to both consumers and health care providers.
母亲安全是一个免费的电话咨询服务，为澳大利亚的消费者和医疗保健提供者提供有关怀孕期间和母乳喂养期间药物暴露的咨询服务。与母乳喂养相关的咨询电话相对常见，并且是母乳喂养母亲感到非常困扰的主要原因，尤其是如果对于药物暴露对婴儿可能产生的不良影响缺乏明确性。本研究旨在确定母乳喂养母亲关注的药物暴露情况，以及可用于解决这些问题的信息。
本研究回顾了 2000 年至 2018 年期间母亲安全热线接到的 19 年有关母乳喂养药物暴露的咨询电话，并重点介绍了关注的药物和咨询问题。本研究采用前瞻性收集的 Access 数据库进行回顾性描述性评估。电话咨询记录确定了有关母乳喂养的药物（和其他）暴露情况。还审查了消费者和产品信息（PI）中提供的有关通过母乳喂养暴露药物的信息。
在 2000 年至 2018 年间，母亲安全热线共接到 315158 个电话，其中 116876 个（37.1%）与通过母乳喂养暴露药物有关；30%的电话与非甾体抗炎药、抗组胺药、抗抑郁药、简单镇痛药和抗生素有关，5%的电话与母乳喂养时明确禁忌的药物暴露有关。
关于通过母乳喂养暴露药物的查询代表了母亲安全热线所有咨询电话的很大一部分。本研究表明，消费者和 PI 表以及在线信息中关于母乳喂养暴露的信息不一致，且往往具有误导性，并强调了像母亲安全这样的致畸信息服务在为消费者和医疗保健提供者提供基于证据的信息方面的重要作用。
