The awareness of the inherent risks attached to medication use during pregnancy is increasing. There is, however, a paucity of available following childbirth. We have conducted a prospective study in women who gave birth in hospital with the objective of analysing the use of medication in this lying in period. The results show that, in addition to the vitamins and minerals routinely prescribed for every young mother and the antipyretics administered as required, the following medicaments were most often used: analgesics (by approx. 9%), anti-inflammatory agents (49%) and antibiotics (38%). The antibiotics were either used prophylactically or, in cases of proven infection, administered therapeutically. The use of antibiotics appears more intensive compared to western countries, presumably due to the greater risk of infection in this group in India. On the other hand, the use of sleep inducing medication and tranquillizers during the lying in period appears, in comparison to other studies, almost negligible. The majority of the women were unaware of the potential side-effects of medication during breastfeeding.
PIP: A prospective analysis was conducted on 539 women, 18-40 years old, admitted to the postpartum unit at the Christian Medical College Hospital in Vellore, India, during June-September 1989 to learn prescribing patterns during the puerperium and the side effects of the drugs in the mother and the breast fed infant and to examine the attitudes of the mothers to drug use during breast feeding and their knowledge of possible side effects. 95.7% breast fed their newborns. 68.5% received at least three drugs. All the mothers received a combination of iron and folic acid and calcium lactate. The next most commonly prescribed drug category was antipyretics (53.1%) followed by anti-inflammatory drugs (49.2%), antibiotics (37.8%), and analgesics (13.9%). 0.2% of all the mothers received sedatives. 96.4% of women who underwent assisted delivery (forceps and vacuum extraction) and 80% who underwent cesarean section (CS) received antipyretics. Most CS patients also received antibiotics (96%) and analgesics (70%). Among the women receiving antibiotics, 73.5% received it for prophylactic reasons and 26.5% for therapeutic reasons. 20.8% of women who had a normal delivery received antibiotics. 37.8% of mothers who chose to breast feed received antibiotics, even metronidazole, which is contraindicated in the newborn. Only four of all the physicians knew that drug use during lactation should be avoided. 16.3% of mothers knew that drug use during lactation would affect their newborn. Almost all these mothers knew that drugs are secreted in breast milk. 29.7% of the mothers who had delivered before the index delivery could name drugs prescribed during previous deliveries. None had noted any side effects either in themselves or in their infants.