Abstract
There is a need to assess the knowledge of healthcare providers on the use of maternal analgesics during lactation; however, valid instruments are not yet available. This study aimed to develop and test a valid questionnaire on the knowledge of analgesics (acetaminophen, ibuprofen, aspirin, tramadol, codeine, oxycodone) during lactation, using a structured, stepwise approach. As a first step, literature was screened to generate a preliminary version consisting of a pool of item subgroups. This preliminary version was subsequently reviewed during two focus groups (midwives: n = 4; pediatric nurses: n = 6), followed by a two-round online Delphi with experts (n = 7) to confirm item and scale content validity. This resulted in an instrument consisting of 33 questions and 5 specific clinical case descriptions for both disciplines. Based on the assumption of an a priori difference in knowledge between midwives and pediatric nurses related to their curricula (known-groups validity), high construct validity was demonstrated in a pilot survey (midwives: n = 86; pediatric nurses: n = 73). We therefore conclude that a valid instrument to assess knowledge on lactation-related exposure to analgesics was generated, which could be further validated and used for research and educational purposes. As these pilot findings suggest suboptimal knowledge for both professions on this topic, adaptations to their curricula and postgraduate training might be warranted.
Highlights
Breastfeeding has multiple benefits for both mother and infant [1]
The study consisted of three parts: (1) development of an instrument to assess the knowledge of midwives and pediatric nurses on the use of analgesics during lactation; (2) content validation of this instrument; (3) pilot use of this instrument in a cohort of midwives and pediatric nurses
This study aimed to develop and pilot test an instrument to assess the knowledge of midwives and pediatric nurses in the maternal use of analgesics during lactation
Summary
Breastfeeding has multiple benefits for both mother (such as lower postpartum blood losses; faster postpartum weight normalization; lower risk for type 2 diabetes, breast or ovarian cancer; lower incidence of osteoporosis) and infant (such as lower risk of gastrointestinal, respiratory and urinary tract infections; lower risk for type 2 diabetes or obesity; better neurodevelopment) [1]. The use of medicines during lactation is very common, as taking medicines can be appropriate or necessary to protect, improve or restore maternal health. This can result in unintended exposure to the nursing infant [2,3]. The ultimate goals of maternal medicine use during breastfeeding are dual. Effective and safe medicines should be provided for a diversity of maternal indications (e.g., postpartum maternal analgesia, maternal co-morbidities, pregnancy/breastfeeding related diseases or vaccinations).
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