Medications, "Natural" Products, and Pharmacovigilance during Breastfeeding: A Mixed-Methods Study on Women's Opinions

Background: In cases of pharmacotherapy, mothers are confronted with the dilemma of breastfeeding and giving up the medication or discontinuing breastfeeding in order to take the drug, thus avoiding any potential risk for the infants. Objective: This study aimed to describe women’s opinions on the use of medications and “natural” products during breastfeeding, pharmacovigilance and phytosurveillance, and the management of breastfeeding. Methods: This was a mixed-methods study with a sequential exploratory design. In the first qualitative phase, we conducted focus groups and in-depth interviews with 25 mothers attending community services. Coding and content analysis were carried out using NVivo9. We identified 4 main categories, and on this basis, we built a questionnaire administered to 248 pregnant women and new mothers attending 2 third-level hospitals. We conducted a descriptive and bivariate analysis (P ≤ .05) using Epi-Info v.7. Results: Women show 3 main attitudes: (1) to discontinue breastfeeding in order to take the medication, (2) to “endure the pain,” or (3) to use so-called natural products, perceived safer than drugs. Women expressing an “endure the pain” opinion and women who considered natural products to be safer than medications had a higher probability of knowing that babies should be exclusively breastfed for the first 6 months (respectively, odds ratio [OR] = 2.24; 95% confidence interval [CI], 1.26-3.97; OR = 4.77; 95% CI, 2.56-8.88). Conclusion: In the dilemma of the mothers needing drug treatment, health professionals play a crucial role. They should convey evidence-based information on the compatibility of drugs with breastfeeding and provide individualized treatments, tailored to the single mother–baby case.