Pregnant? Breastfeeding? Sick? Reluctant to take medication for fear it will harm your baby? You’re not alone. Expectant and new parents have long received mixed messages when it comes to drug safety. Now, with more and more parents turning to the internet for health information, the ability to separate fact from fiction has never been more crucial.
Monica Akus, PharmD and Melissa Bartick, MD in 2007 were among the first to examine the reliability of 10 commonly used sources of drug information. (See complete list below.) They found that many of the recommendations contained therein were not supported by up-to-date research, particularly those from retail pharmacies. They also discovered that inaccurate printed recommendations, such as, Do not use while breastfeeding, can undermine the credibility of the health care provider who tells a mother, correctly, that a drug is safe.
Absent from the list of resources examined by Akus and Bartick was Wikipedia—a resource reportedly used by 74 percent of American adults looking online for health information. Wikipedia currently ranks 7th among the most visited sites on the web. Using keywords from three health indexes, researchers found that Wikipedia ranked among the first 10 results in 71–85 percent of search engines and keywords tested, with its articles viewed more frequently than the corresponding MedlinePlus.
Data also show that Wikipedia isn’t just for consumers. A 2009 survey of 1,900 U.S. physicians found that 50 percent used Wikipedia to answer their health questions. Slightly higher rates (nearly two-thirds) were reported among their European counterparts. However, a recent review of Wikipedia’s drug information revealed that it was inconsistent and incomplete. This should come as no surprise given that Wikipedia is written and edited largely by anonymous internet volunteers. According to the website, “Anyone with internet access can write and make changes to Wikipedia articles, except in limited cases where editing is restricted to prevent disruption or vandalism.”
These results highlight the importance of using more than one resource when determining the safety of drugs or other remedies. Whether it’s WedMD, MedLinePlus, the FDA, or the CDC, parents and health care providers alike should do themselves a favor and double up.
While parents tend to look at the bottom line—whether the drug is safe or unsafe—health care providers want to know the drug’s characteristics (bioavailability, molecular weight, half-life, peak interval, protein binding, and fat solubility) as well as the characteristics of the infant (gestational age, post-birth age, weight, overall health). Drugs that may be safe for healthy, term babies may be unsafe for premature or sick babies. Similarly, drugs that may be safe for older children may not be safe for younger children.
When making decisions about drug use follow these basic guidelines:
Choose, along with your health care provider or your baby’s health care provider, the safest drug available.
Watch for side effects in yourself and in your baby.
Breastfeeding mothers should continue to breastfeed, unless two reliable sources tell you to stop. Too often mothers who need to take drugs to treat an illness or alleviate pain are told, incorrectly, to stop breastfeeding. When in fact there are very few drugs (chemotherapeutic drugs being one) that are incompatible with breastfeeding.
When researching online whether a drug is suitable to take if pregnant or breastfeeding, or whether a particular medication is safe for you or your child, consider the following sources:
American Academy of Pediatrics (AAP) Policy Statement—published periodically and available free online
LactMed—free online resource from the National Library of Medicine
Medications and Mother’s Milk (MMM)—book by Dr. Thomas Hale that is updated every two years and is available in hard copy or online
Drugs in Pregnancy and Lactation (DPL)—book by Dr. Gerald Briggs last updated in 2011
Microdex—free app available on mobile devices
Lexi-Comp—purchase app available on mobile devices and online
Epocrates—purchase app available for mobile devices and online
First DataBank—retail pharmacy database
Clin-eguide—retail pharmacy database
Physician’s Desk Reference—compilation of package inserts from drug manufacturers available free online or download mobile app
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