Document Type
Dissertation
Date of Degree
Summer 2024
Primary Advisor
Joseph Bocchino
Keywords
Lactation; Breastfeeding; Prescriptions; Medications
Abstract
Human breast milk is universally recognized as the optimal source of nutrition for infants, offering long-term health benefits for both child and the lactating mother. However, breastfeeding complicates medical decision-making associated with maternal medication use. Though reports of infant adverse events from medication transferred into breast milk are rare, there is a lack of clinical trial data or clear practice guidelines to assess the associated risks and benefits of medications versus breastfeeding to the maternal-infant dyad. In the face of a lack of data, healthcare providers still must treat the medical issues breastfeeding women have.
This study provides the previously unexplored pharmacoepidemiologic landscape of the prescribing practices of healthcare providers to lactating women (BFx) by developing and applying a novel mechanism to identify lactating women in commercial claims data in the US. Descriptive data from prescriptions to lactating women were used to assess prescribing concordance with expert recommendations for safety in the breastfeeding infant and develop a model for understanding lactation prescribing performance.
The characteristics of the medications prescribed suggest a cautious approach to prescribing, with a preference for medications that have lactation data available. Prescriptions following expert BFx recommendations were most likely to be written by obstetricians, though this specialty group only accounts for one-third of prescriptions to breastfeeding women. Women under 35 years old, living in the Western U.S., more than 14 days postpartum, and receiving a short-duration prescription for a chronic condition from a family practice provider exhibited the highest odds of prescribing concordance.
The insights gained from this study will shape future research agendas, inform lactation data collection in medical records, and guide clinical educational content, thereby advancing the field of maternal and infant health.
Recommended Citation
Krutsch, Kaytlin, "Characteristics of Prescribing and Determinants of Prescribing Performance in Lactating Women: Secondary Analysis of Marketscan U.S. Commercial Claims Data" (2024). Doctor of Philosophy in Translational Health Sciences Dissertations. Paper 32.
https://hsrc.himmelfarb.gwu.edu/smhs_crl_dissertations/32
Open Access
1
Included in
Chemical and Pharmacologic Phenomena Commons, Medicinal and Pharmaceutical Chemistry Commons, Translational Medical Research Commons, Women's Health Commons
Comments
©2024 by Kaytlin Krutsch. All rights reserved.