Medication Intake as a Factor for Non-Initiation and Cessation of Breastfeeding: A Prospective Cohort Study in Greece during the COVID-19 Pandemic
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Ethical Considerations
- General and Maternity Hospital “HELENA VENIZELOU” (24285/29 October 2019)
- “ATTIKON” General University Hospital (570/1 October 2019)
- “ALEXANDRA” General Hospital (511/20 July 2020)
- “IASO” General Maternity and Gynecology Clinic (30 May 2019)
- “LETO” General, Maternity and Gynecology Clinic (174a/5 June 2019)
2.2. Sample and Setting
2.3. Data Collection
2.4. Measurements
2.5. Drug Classification
- Lactmed 1 includes the categories: “Compatible”; “Limited Data (LD). Compatible”;
- Lactmed 2 includes the categories: “Probably Compatible”; “Limited Data (LD). Probably Compatible”; “Probably Compatible. May reduce milk supply”;
- Lactmed 3 includes the categories: “Limited Data (LD). Use alternative drugs”; “No Data (ND). Use alternative drugs”; “Use alternative drugs. May suppress lactation”;
- Lactmed 4 includes the categories: “No Data (ND). Use with caution. Avoid during lactation”; “Avoid during lactation. Potential toxicity to the infant”.
- Level 1 (L1): compatible;
- Level 2 (L2): probably compatible: Drug that has been studied in a limited number of breastfeeding women, without an increase in adverse effects in the infant. And/or the evidence of a demonstrated risk which is likely to follow the use of this medication in a breastfeeding woman is remote;
- Level 3 (L3): probably compatible: There are no control studies in breastfeeding women; however, the risk of untoward effects to a breastfed infant is possible, or controlled studies show only minimal non-threatening adverse effects. Drugs should be given only if the potential benefit justifies the potential risk to the infant. (New medications that have absolutely no published data are automatically categorized in this category, regardless of how safe they are);
- Level 4 (L4): potentially hazardous: There is positive evidence of risk to a breastfed infant or to breast milk production, but the benefits of use in breastfeeding mothers may be acceptable despite the risk to the infant;
- Level 5 (L5): hazardous.
- Lactmed 1, Lactmed 2, L1 (Hale) and L2 (Hale);
- Lactmed 3, L3 (Hale);
- Lactmed 4, L4 (Hale) and L5 (Hale).
2.6. Data Analysis
3. Results
3.1. Basic Sample Characteristics
3.2. Maternal Medication Intake during Postpartum Period
3.2.1. Compatibility with Breastfeeding
3.2.2. Medication Intake as a Reason for Breastfeeding Cessation
3.2.3. Factors Associated with Breastfeeding Cessation due to Medication Intake
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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BF Cessation due to Medication Intake | OR (95% CI) | p-Value |
---|---|---|
Qualitative variables | ||
Physician’s recommendation for BF cessation due to medication intake On physician’s recommendation Women without recommendation by a physician to discontinue BF | 93.9 (45.6–193.4) Ref | <0.001 |
Medication intake for chronic disease Women who received medication for chronic diseases Women who did not receive medication for chronic diseases | 4.6 (2.6–8.2) Ref | <0.001 |
Mode of delivery Cesarean section Vaginal delivery | 2.8 (1.4–5.8) Ref | 0.005 |
Non-employment at 6 months after delivery Not employed Maternity leave Work suspension due to COVID-19 pandemic Teleworking due to COVID-19 pandemic Mothers working at 6 months postpartum | 0.54 (0.27–1.06) 0.10 (0.02–0.40) 0.08 (0.01–0.62) 0.17 (0.05–0.54) Ref | <0.001 |
Educational level College University Postgraduate studies Women with education up to High School | 0.7 (0.3–1.6) 0.6 (0.3–1.1) 0.2 (0.1–0.6) Ref | 0.034 |
Nationality Greek Others | Ref | 0.467 |
Employment before pregnancy Women working before pregnancy Women not working before pregnancy | Ref | 0.727 |
Quantitative variables | ||
Previous BF experience (days) | 0.994 (0.992–0.997) | <0.001 |
Maternal age | 0.444 | |
Parity | 0.601 |
BF Cessation due to Medication Intake | OR (95% CI) | p-Value |
---|---|---|
Physician’s recommendation for BF cessation due to medication intake On physician’s recommendation Women without recommendation by a physician to discontinue BF | 171.44 (67.401–436.075) Ref | <0.001 |
Mode of delivery Cesarean section Vaginal delivery | 6.097 (2.062–18.025) Ref | 0.001 |
Type of hospital Private Public | 2.261 (0.981–5.209) Ref | 0.055 |
Smoking before pregnancy (cigarettes/day) | 1.103 (1.059–1.149) | <0.001 |
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Tigka, M.; Metallinou, D.; Nanou, C.; Iliodromiti, Z.; Gryparis, A.; Lykeridou, K. Medication Intake as a Factor for Non-Initiation and Cessation of Breastfeeding: A Prospective Cohort Study in Greece during the COVID-19 Pandemic. Children 2023, 10, 586. https://doi.org/10.3390/children10030586
Tigka M, Metallinou D, Nanou C, Iliodromiti Z, Gryparis A, Lykeridou K. Medication Intake as a Factor for Non-Initiation and Cessation of Breastfeeding: A Prospective Cohort Study in Greece during the COVID-19 Pandemic. Children. 2023; 10(3):586. https://doi.org/10.3390/children10030586
Chicago/Turabian StyleTigka, Maria, Dimitra Metallinou, Christina Nanou, Zoi Iliodromiti, Alexandros Gryparis, and Katerina Lykeridou. 2023. "Medication Intake as a Factor for Non-Initiation and Cessation of Breastfeeding: A Prospective Cohort Study in Greece during the COVID-19 Pandemic" Children 10, no. 3: 586. https://doi.org/10.3390/children10030586