Background: Breastfeeding is a major public health issue in terms of its benefits to both mothers and infants. Despite recommendations, breastfeeding initiation and duration are low in many industrialized countries. Although human milk is viewed as the most appropriate food for infants, when it is perceived as contaminated, doubts about its quality can lead to negative behaviors concerning breastfeeding. This is especially true when mothers are taking medication. Research aim: The aim of this review is to evaluate the data in the literature on the knowledge, representations, attitudes, and behaviors of women with regard to taking medication while breastfeeding. These elements should aid our understanding of how the mothers’ behaviors are constructed in this situation. Methods: The authors conducted a scoping review to map and analyze the available data from literature sources regarding breastfeeding mothers’ knowledge, representations, attitudes, and behaviors about medicines. A staged approach to the scoping review was used. Results: Eighteen studies met the selection criteria. They described safety behaviors like noninitiation, duration reduction, breastfeeding cessation, and refusal to take medication in order to breastfeed. Most showed a conflict between taking medication and breastfeeding. Because the knowledge, representations, and attitudes behind such behaviors have received very little study, it is difficult to explain how these behaviors are constructed. Conclusion: The results of this review confirm the need for a qualitative study to explore the knowledge, representations, and attitudes of breastfeeding women faced with taking medications, so that we can understand their connection with observed behaviors and take appropriate educational action.

Taking medication during breastfeeding is often a major concern for mothers. Knowledge, representations, and attitudes condition a mother’s behavior in this situation. Healthcare professionals, whose medication advice for breastfeeding women is often described in scientific literature as inappropriate, play a major role in counseling mothers. Healthcare professionals’ perceptions of mothers’ behaviors regarding medication use during breastfeeding may influence mothers’ behaviors. The aim of this study was to identify healthcare professionals’ perceptions of breastfeeding women’s knowledge, representations, and attitudes and behaviors about medication use. A cross-sectional, prospective qualitative design was used. Semistructured interviews were conducted with a broad array of healthcare professionals (N = 20) in different practice settings in the Angers area (France). Thematic analysis of the interview transcripts was carried out using the planned behavior theory of Ajzen. Seventy themes concerning medication use while breastfeeding were identified and then combined into 8 categories. Healthcare professionals perceived that maternal behaviors regarding medication were mostly focused on the child’s safety and were linked to poor knowledge and negative representations, attitudes, and feelings toward medication. Healthcare professionals also perceived significant negative influences from the mother’s friends and family in regard to breastfeeding. Relationships between healthcare professionals and women were problematic when it came to drug use during breastfeeding. Taking into account healthcare professionals’ perceptions of maternal behavior will help improve education for these professionals. Indeed, knowing precisely what difficulties are met by healthcare professionals when they encounter medication use during breastfeeding can help educators improve training for these professionals.

This commentary follows the article of Moni R. Saha and her co-authors, entitled

Aging is associated with a decline in functional capacities, which can lead to challenges in medication preparation. Identifying these issues appears essential. The objectives of this study were to describe the proportion of pharmaceutical interventions carried out following the identification of patient difficulties in preparing and administering medications, and to characterize the difficulties identified. Descriptive cross-sectional study with data collected during 42 pharmaceutical interviews with patients hospitalized on an acute geriatric ward. The interview consisted of two parts: i) a questionnaire assessing potential difficulties, and ii) direct observation of medication preparation using pharmaceutical forms similar to those usually prescribed to the patient. The main outcome was the occurrence of at least one pharmaceutical intervention following the identification of difficulties. Pharmaceutical intervention was suggested to 95.0 % of patients where a difficulty was identified, representing 45.2 % of patients included. Interventions included education on correct use (16.0 %), substitution of pharmaceutical forms (16.0 %), implementation of tools for patients (36.0 %) and home assistance (32.0 %). These interventions were accepted by the geriatrician in all cases and by the patient in 80.0 %. At least one difficulty was identified for 47.7 % of the patients. This study shows that identifying functional difficulties in medication preparation enables tailored interventions to address these issues. Observing older adults' abilities to manage their medication could reduce the risk of medication errors and probably enhance their daily quality of life.