The United States Food and Drug Administration’s Pregnancy and Lactation Labeling Final Rule requires pharmaceutical manufacturers to include summaries of product risks during pregnancy and lactation. However, as of May 2020 only 3% of newly approved medications had lactation safety data from human studies.
The authors of this week’s study were interested in identifying the most common medications dispensed to lactating individuals, as this information might help to prioritize the medications for which safety information is needed. They used the electronic health records from a large US healthcare system in Minnesota USA that documents infant feeding type at well child visits, and analyzed infant feeding data from the 2-,4- and 6-month visits from May 2018-June 2019. They assumed that parents of infants receiving human milk were lactating, and reviewed medications dispensed to the lactating mothers within a few weeks of the 2-month visit. They did not include IUDs, contraceptive implants or medications given during hospitalization.
Among 6,099 infants with infant feeding type recorded, 4198 infants were identified as receiving human milk at the 2-month visit. The average maternal age was 31 years, and 63.2% were non-Hispanic White. Sixty-six percent had commercial insurance, and 32.4% were insured by Medicaid. They found that 20.9% of the mothers had a diagnosis of anxiety disorder and 11.6% had a mood disorder.
The researchers found that the top 3 most common medications prescribed around 2 months postpartum included oral progesterone-only contraceptives, selective serotonin reupdate inhibitor (SSRI) antidepressants, and antibiotics, in that order.
The researchers were able to track the frequency of medication use in this population over time, after verifying that they continued to provide human milk at the 4- and 6-month visits.
What else? See the question!
Amanda
I assumed cephalexin and cefadroxil were prescribed for incisional cellulitis (the most common reason I prescribe these for postpartum patients, using dicloxacillin first-line for mastitis), though even 2 months is a bit late for cellulitis.