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Where are the data linking infant outcomes, breastfeeding and medicine exposure? A systematic scoping review

Sophia Komninou Orcid Logo, Sue Jordan Orcid Logo, Sandra Lopez Leon

PLOS ONE, Volume: 18, Issue: 4, Start page: e0284128

Swansea University Authors: Sophia Komninou Orcid Logo, Sue Jordan Orcid Logo

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DOI (Published version): 10.1371/journal.pone.0284128

Abstract

IntroductionInformation on the impact of medicines on breastfeeding and the breastfed infant remains scarce. The aims of this review were to identify databases and cohorts holding this information, and pinpoint current information and research deficits.MethodWe searched 12 electronic databases, incl...

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ISSN: 1932-6203
Published: Public Library of Science (PLoS) 2023
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A systematic scoping review</title><swanseaauthors><author><sid>ae112e20f29a2a4b0acdfb3abb2ec6a9</sid><ORCID>0000-0002-3835-8302</ORCID><firstname>Sophia</firstname><surname>Komninou</surname><name>Sophia Komninou</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>24ce9db29b4bde1af4e83b388aae0ea1</sid><ORCID>0000-0002-5691-2987</ORCID><firstname>Sue</firstname><surname>Jordan</surname><name>Sue Jordan</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2023-05-12</date><deptcode>PHAC</deptcode><abstract>IntroductionInformation on the impact of medicines on breastfeeding and the breastfed infant remains scarce. The aims of this review were to identify databases and cohorts holding this information, and pinpoint current information and research deficits.MethodWe searched 12 electronic databases, including PubMed/ Medline and Scopus, using a combination of controlled vocabulary (MeSH terms) and free text terms. We included studies reporting data from databases with information on breastfeeding, medicines exposure, and infant outcomes. We excluded studies not reporting all three parameters. Two reviewers independently selected papers and extracted data using a standardised spreadsheet. Risk of bias was assessed. Recruited cohorts with relevant information were tabulated separately. Discrepancies were resolved by discussion.ResultsFrom 752 unique records, 69 studies were identified for full review. Eleven papers reported analyses from ten established databases with information on maternal prescription or non-prescription drugs, breastfeeding and infant outcomes. Twenty-four cohort studies were also identified. No studies reported educational or long-term developmental outcomes. The data are too sparse to warrant any firm conclusions, beyond the need for more data. The overall picture hints at 1) unquantifiable, but probably rare, serious harms to infants exposed to medicines via breastmilk, 2) unknown long-term harms, and 3) a more insidious but more pervasive harm in terms of reduced breastfeeding rates following medicines exposure in late pregnancy and peri-partum.ImplicationsAnalyses of databases reporting on the full population are needed to quantify any adverse effects of medicines and identify dyads at risk of harm from prescribed medicines while breastfeeding. This information is essential to ensure 1) infants are monitored appropriately for any adverse drug reactions 2) inform breastfeeding patients using long-term medicines as to whether the benefits of breastfeeding outweigh exposure to medicines via breastmilk and 3) target additional support to breastfeeding patients whose medicines may affect breastfeeding. 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spelling v2 63442 2023-05-12 Where are the data linking infant outcomes, breastfeeding and medicine exposure? A systematic scoping review ae112e20f29a2a4b0acdfb3abb2ec6a9 0000-0002-3835-8302 Sophia Komninou Sophia Komninou true false 24ce9db29b4bde1af4e83b388aae0ea1 0000-0002-5691-2987 Sue Jordan Sue Jordan true false 2023-05-12 PHAC IntroductionInformation on the impact of medicines on breastfeeding and the breastfed infant remains scarce. The aims of this review were to identify databases and cohorts holding this information, and pinpoint current information and research deficits.MethodWe searched 12 electronic databases, including PubMed/ Medline and Scopus, using a combination of controlled vocabulary (MeSH terms) and free text terms. We included studies reporting data from databases with information on breastfeeding, medicines exposure, and infant outcomes. We excluded studies not reporting all three parameters. Two reviewers independently selected papers and extracted data using a standardised spreadsheet. Risk of bias was assessed. Recruited cohorts with relevant information were tabulated separately. Discrepancies were resolved by discussion.ResultsFrom 752 unique records, 69 studies were identified for full review. Eleven papers reported analyses from ten established databases with information on maternal prescription or non-prescription drugs, breastfeeding and infant outcomes. Twenty-four cohort studies were also identified. No studies reported educational or long-term developmental outcomes. The data are too sparse to warrant any firm conclusions, beyond the need for more data. The overall picture hints at 1) unquantifiable, but probably rare, serious harms to infants exposed to medicines via breastmilk, 2) unknown long-term harms, and 3) a more insidious but more pervasive harm in terms of reduced breastfeeding rates following medicines exposure in late pregnancy and peri-partum.ImplicationsAnalyses of databases reporting on the full population are needed to quantify any adverse effects of medicines and identify dyads at risk of harm from prescribed medicines while breastfeeding. This information is essential to ensure 1) infants are monitored appropriately for any adverse drug reactions 2) inform breastfeeding patients using long-term medicines as to whether the benefits of breastfeeding outweigh exposure to medicines via breastmilk and 3) target additional support to breastfeeding patients whose medicines may affect breastfeeding. The protocol is registered with the Registry of Systematic Reviews, no.994. Journal Article PLOS ONE 18 4 e0284128 Public Library of Science (PLoS) 1932-6203 26 4 2023 2023-04-26 10.1371/journal.pone.0284128 http://dx.doi.org/10.1371/journal.pone.0284128 COLLEGE NANME Public Health COLLEGE CODE PHAC Swansea University SU Library paid the OA fee (TA Institutional Deal) ConcePTION consortium 2023-09-13T15:59:30.1144927 2023-05-12T10:39:17.5139307 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Sophia Komninou 0000-0002-3835-8302 1 Sue Jordan 0000-0002-5691-2987 2 Sandra Lopez Leon 3 63442__27606__d443a3bb5ace40e9b8d719ca77e00616.pdf 63442.pdf 2023-05-24T16:16:36.3092819 Output 736200 application/pdf Version of Record true Copyright: © 2023 Jordan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. true eng http://creativecommons.org/licenses/by/4.0/ 187 sue jordan 0000-0002-5691-2987 s.e.jordan@swansea.ac.uk false 4
title Where are the data linking infant outcomes, breastfeeding and medicine exposure? A systematic scoping review
spellingShingle Where are the data linking infant outcomes, breastfeeding and medicine exposure? A systematic scoping review
Sophia Komninou
Sue Jordan
title_short Where are the data linking infant outcomes, breastfeeding and medicine exposure? A systematic scoping review
title_full Where are the data linking infant outcomes, breastfeeding and medicine exposure? A systematic scoping review
title_fullStr Where are the data linking infant outcomes, breastfeeding and medicine exposure? A systematic scoping review
title_full_unstemmed Where are the data linking infant outcomes, breastfeeding and medicine exposure? A systematic scoping review
title_sort Where are the data linking infant outcomes, breastfeeding and medicine exposure? A systematic scoping review
author_id_str_mv ae112e20f29a2a4b0acdfb3abb2ec6a9
24ce9db29b4bde1af4e83b388aae0ea1
author_id_fullname_str_mv ae112e20f29a2a4b0acdfb3abb2ec6a9_***_Sophia Komninou
24ce9db29b4bde1af4e83b388aae0ea1_***_Sue Jordan
author Sophia Komninou
Sue Jordan
author2 Sophia Komninou
Sue Jordan
Sandra Lopez Leon
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publisher Public Library of Science (PLoS)
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
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department_str School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
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description IntroductionInformation on the impact of medicines on breastfeeding and the breastfed infant remains scarce. The aims of this review were to identify databases and cohorts holding this information, and pinpoint current information and research deficits.MethodWe searched 12 electronic databases, including PubMed/ Medline and Scopus, using a combination of controlled vocabulary (MeSH terms) and free text terms. We included studies reporting data from databases with information on breastfeeding, medicines exposure, and infant outcomes. We excluded studies not reporting all three parameters. Two reviewers independently selected papers and extracted data using a standardised spreadsheet. Risk of bias was assessed. Recruited cohorts with relevant information were tabulated separately. Discrepancies were resolved by discussion.ResultsFrom 752 unique records, 69 studies were identified for full review. Eleven papers reported analyses from ten established databases with information on maternal prescription or non-prescription drugs, breastfeeding and infant outcomes. Twenty-four cohort studies were also identified. No studies reported educational or long-term developmental outcomes. The data are too sparse to warrant any firm conclusions, beyond the need for more data. The overall picture hints at 1) unquantifiable, but probably rare, serious harms to infants exposed to medicines via breastmilk, 2) unknown long-term harms, and 3) a more insidious but more pervasive harm in terms of reduced breastfeeding rates following medicines exposure in late pregnancy and peri-partum.ImplicationsAnalyses of databases reporting on the full population are needed to quantify any adverse effects of medicines and identify dyads at risk of harm from prescribed medicines while breastfeeding. This information is essential to ensure 1) infants are monitored appropriately for any adverse drug reactions 2) inform breastfeeding patients using long-term medicines as to whether the benefits of breastfeeding outweigh exposure to medicines via breastmilk and 3) target additional support to breastfeeding patients whose medicines may affect breastfeeding. The protocol is registered with the Registry of Systematic Reviews, no.994.
published_date 2023-04-26T15:59:32Z
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