Community pharmacists' experience, attitudes, and knowledge in providing care to lactating persons

Introduction

Breastfed infants have been shown to have a lower incidence of common childhood infections and sudden infant death syndrome. Furthermore, breastfeeding people experience lower rates of post-partum mood disorders. The majority of breastfeeding people stop breastfeeding earlier than they intend. Concern about medication use during lactation is one reason for early discontinuation. It is critical that community pharmacists are prepared to appropriately counsel lactating patients on the effects medications can have on their efforts to breastfeed.

Objectives

To (1) characterize community pharmacists' experience, attitudes, and knowledge regarding medication use during lactation and (2) identify factors impacting pharmacists' knowledge.

Methods

A 52-item electronic survey was used to collect demographics, experiences, attitudes, and knowledge regarding medication use during lactation. Community pharmacists who precepted for a Big Ten College of Pharmacy were eligible to participate in the study. Descriptive statistics were calculated using Microsoft Excel. Multivariable linear regression was performed using R (version 3.6.1) to evaluate which factors influenced total knowledge scores.

Results

Forty-eight of 1029 pharmacy preceptors (4.7%) completed the survey. The average total knowledge score for respondents was 51.3%. Most (80.0%) respondents agreed or strongly agreed they viewed themselves as valuable healthcare resources to breastfeeding patients. Most (82.5%) agreed or strongly agreed that patients who desire information about how medications can impact breastfeeding will directly ask for it. Fewer than 50% agreed or strongly agreed that pharmacy workflow supported them to look up lactation-related information while working.

Conclusion

Pharmacists have low knowledge of medications' effects on milk supply despite their positive attitudes towards breastfeeding and belief they are valuable healthcare resources to their breastfeeding patients. Workflow barriers, expectations that patients will ask for lactation-related information if desired, and gaps in education may be key contributors to lactating patients not getting the information they need regarding medication use.