Lower Adherence to Breastfeeding Recommendations in Mothers Treated With Antirheumatic and Antidepressant Medications.

IF 2.1 4区医学 Q2 NURSING

Journal of Human Lactation Pub Date : 2025-05-27 DOI:10.1177/08903344251337384

Essi Whaites Heinonen, Diana L Johnson, Alec Todd, Christina D Chambers

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引用次数: 0

Abstract

Background: Exclusive breastfeeding for 6 months is recommended, but breastfeeding safety data is insufficient for several medications.

Aim: To determine if mothers treated with chronic medications are less likely to breastfeed.

Methods: For this secondary analysis, 6383 pregnant women in the MotherToBaby cohort recruited from the United States and Canada between 2010 and 2022 were included. Participants treated with antirheumatic medications (ARM), selective serotonin reuptake inhibitors (SSRIs), and asthma medications during pregnancy were divided into two groups based on their medication use: continuers and discontinuers. Breastfeeding initiation, supplementation with commercial milk formula, and discontinuation of breastfeeding before 6 months were compared between those exposed and unexposed to medication use. Adjusted risk and hazard ratios (aRR, aHR) and 95% Confidence Intervals (CI) were calculated with modified Poisson and Cox regressions adjusted for year, parity, socioeconomic status, body mass index, smoking, illicit drug use, race and ethnicity.

Results: The sample included 799 (12.5%) continuers and 475 (7.4%) discontinuers of ARM, 293 continuers (4.6%) and 63 (1.0%) discontinuers of SSRIs, and 217 (3.4%) continuers and 97 (1.5%) discontinuers of asthma medications. There were 4,439 (69.6%) participants who were unexposed to the study medications. Both ARM continuers and discontinuers were more likely to not breastfeed (aRRs 95% CI: 3.92 [3.03, 5.07] and 3.08 [2.19, 4.33]), to supplement (aRRs 95% CI: 1.12 [1.01, 1.26] and 1.25 [1.10, 1.43]) and stop breastfeeding before 6 months (aHRs 95% CI: 1.72 [1.29, 2.31] and 1.41 [0.92, 2.15]). SSRI continuers were more likely to supplement (aRR 95% CI: 1.26 [1.08, 1.47]).

Conclusion: Participants treated with chronic medications, primarily ARMs, were less likely to breastfeed. Targeted lactation support for mothers with chronic illnesses is recommended along with development of breastfeeding safety data for these medications.

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服用抗风湿和抗抑郁药物的母亲对母乳喂养建议的依从性较低。

背景：建议纯母乳喂养6个月，但母乳喂养的安全性数据对几种药物不足。目的：确定接受慢性药物治疗的母亲是否更不可能母乳喂养。方法：在这项二级分析中，纳入了2010年至2022年间从美国和加拿大招募的6383名母婴队列孕妇。怀孕期间接受抗风湿药物（ARM）、选择性血清素再摄取抑制剂（SSRIs）和哮喘药物治疗的参与者根据用药情况分为两组：继续用药组和停止用药组。比较了6个月前开始母乳喂养、补充商业配方奶粉和停止母乳喂养的暴露者和未暴露于药物使用的人。调整后的风险和危险比（aRR, aHR）和95%置信区间（CI）采用修正泊松和Cox回归计算，校正了年份、胎次、社会经济地位、体重指数、吸烟、非法药物使用、种族和民族。结果：样本中有799人（12.5%）继续服用ARM， 475人（7.4%）停止服用，293人（4.6%）和63人（1.0%）停止服用SSRIs， 217人（3.4%）和97人（1.5%）停止服用哮喘药物。有4,439（69.6%）名参与者未接触研究药物。ARM继续者和停止者更有可能不母乳喂养（aRRs 95% CI: 3.92[3.03, 5.07]和3.08[2.19,4.33]），补充（aRRs 95% CI: 1.12[1.01, 1.26]和1.25[1.10,1.43]），并在6个月前停止母乳喂养（aHRs 95% CI: 1.72[1.29, 2.31]和1.41[0.92,2.15]）。SSRI继续者更有可能补充（aRR 95% CI: 1.26[1.08, 1.47]）。结论：接受慢性药物治疗的参与者，主要是ARMs，更不可能母乳喂养。建议为患有慢性疾病的母亲提供有针对性的哺乳支持，同时发展这些药物的母乳喂养安全性数据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Human Lactation 医学-妇产科学

CiteScore

5.00

自引率

11.50%

发文量

100

审稿时长

6-12 weeks

期刊介绍： Committed to the promotion of diversity and equity in all our policies and practices, our aims are: To provide our readers and the international communities of clinicians, educators and scholars working in the field of lactation with current and quality-based evidence, from a broad array of disciplines, including the medical sciences, basic sciences, social sciences and the humanities. To provide student and novice researchers, as well as, researchers whose native language is not English, with expert editorial guidance while preparing their work for publication in JHL. In each issue, the Journal of Human Lactation publishes original research, original theoretical and conceptual articles, discussions of policy and practice issues, and the following special features: Advocacy: A column that discusses a ‘hot’ topic in lactation advocacy About Research: A column focused on an in-depth discussion of a different research topic each issue Lactation Newsmakers: An interview with a widely-recognized outstanding expert in the field from around the globe Research Commentary: A brief discussion of the issues raised in a specific research article published in the current issue Book review(s): Reviews written by content experts about relevant new publications International News Briefs: From major international lactation organizations.