Information on factors governing GPs' decision-making around prescribing medicines for breastfeeding mothers and their views in such situations is limited so a study was carried out in Melbourne, Australia using an anonymous postal survey to determine knowledge, attitudes and practices on medicines and breastfeeding. A total of 335 (52% of those asked) GPs responded to the survey, and 253 (76%) provided information on the last time they had to decide about the use of medicine for a breastfeeding woman. Conditions reported were mastitis (24%), other infections (24%) and depressive disorders (21%).

 

The key theme that emerged was "complexity of managing risk in prescribing for breastfeeding women". Underlying themes included certainty around decision-making; uncertainty around decision-making; need for drug information to be available, consistent and reliable; joint decision-making; the vulnerable "third party" and infant feeding decision. Decision-making is a spectrum from a straight forward decision, such as treatment of mastitis, to a complicated one requiring multiple inputs and consideration. The authors conclude that GPs felt that prescribing medicines for breastfeeding women is a contentious issue. Without evidence-based information, they sometimes recommend cessation of breastfeeding unnecessarily.