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Australian Pharmacist October 2013 I © Pharmaceutical Society of Australia Ltd.
the general public of having a good
solid relationship with their pharmacist,
like they do with their doctor, these
situations would be less likely to occur.
First-time mums do need assistance, and
shouldn’t be left to think they aren’t doing
Many pharmacies offer the services of
midwives or community nurses, but
as vendors of infant formula and the
most accessible health professionals in
the community, how can pharmacists
adequately support women who wish
to cease breastfeeding when they
themselves are not supported to do so?
A balancing act
The Pharmacy Guild toes the line when it
comes to infant formula, endorsing WHO
guidelines on exclusively breastfeeding for
the first six months, but it acknowledges
this is not always possible.
In a statement provided on the topic,
outgoing President Kos Sclavos said,
‘ The Guild recognises that there may be
circumstances where mothers may choose
breast-milk substitutes and respects the
right to make an informed choice about
the method of feeding. The Guild believes
that consumers must be provided with
current and accurate evidence-based
information on breastfeeding and bottle
feeding to make an informed choice.’
However the Guild stops short of assisting
its members to provide information
PSA’s Self Care Program has developed
a Medicines and breastfeeding Self Care
Fact Card, but this does not cover infant
formula use or how to bottle-feed.
‘Pharmacists have a responsibility to
provide advice and the most appropriate
products to women who are unable
to breastfeed or need to provide
supplemental bottle feeds to their infants,’
John Bell said.
‘Advice at the time of purchase of baby
formulas is important. Ideally this can be
provided from a pharmacy, but there is
no legislation to require [formula only be
sold in pharmacies] and it’s unlikely there
will be. Perhaps a better option would
be to make sure women are aware that
they will get the best advice about infant
care, including feeding issues, from their
pharmacy rather than at a supermarket.’
While the ABA says it works to establish
positive relationships with health-care
professionals, it would clearly prefer
pharmacists don’t intervene and
instead send consumers to its
helpline, website or counsellors.
‘Pharmacists can play a very positive
role in helping mothers to achieve
their breastfeeding goals. Often new
mothers will seek out the help of a
pharmacy staff if they are suffering nipple
damage or engorgement. Pharmacists
and their staff can act as a referral service
for new mothers to get assistance with
breastfeeding by suggesting the services
offered by the Australian Breastfeeding
Association,’ spokesperson Meredith
Links to postnatal depression
Connections between breastfeeding
difficulties and postnatal depression are
well-established. Most studies confirming
as much do so without even addressing
the effects of rigid programs such as the
Baby Friendly Initiative.
One US study published in 2011 by
the Gillings School of Global Public
Health found that women who had
negative early breastfeeding experiences
were more likely to have depressive
symptoms in line with the Edinburgh
Postnatal depression scale at two
months postpartum. They found of
2,586 women who had reported ever
breastfeeding, 8.6% met criteria for
major depression two months after
birth. Their recommendations included
screening women with breastfeeding
difficulties for depressive symptoms.
Closer to home, Beyond Blue’s Deputy
Chief Executive Nicole Highet told
The Mercury newspaper earlier this year
that many women who cannot breastfeed
suffer anxiety and depression because of
what is doggedly promoted as ‘natural’
‘ There’s a big push among many health
professionals in Australia, and particularly
maternity nurses, that breast is best,’
Dr Highet said. ‘ We’re really committed
to raising awareness among health
professionals about the sensitivities
around breastfeeding and getting health
professionals to reflect on the impact
that their statements and comments
might have on women who might be
During interviews as part of research into
depression and anxiety in new mothers,
Dr Highet said one issue that came up
constantly was the difficulties around
breastfeeding and how women felt great
pressure to breastfeed.
‘If they had difficulties compounding their
feelings of depression and anxiety and
feelings of failure, it really was a kick in the
guts,’ she said.
So, the next time a customer is browsing
infant formulas, take a minute to see how
they are. Chances are they’re in need of
some reassurance and you might just gain
a customer for life.
1. Australian Institute of Health and welfare. 2010 Australian
national infant feeding survey: indicator results. 20
Dec 2011 AIHW. At: www.aihw.gov.au/publication-
2. Neifert MR. Prevention of breastfeeding tragedies. Pediatr Clin
North Am 2001;48(2):273–97.
3. Long-term effects of breastfeeding: a
systematic review. At: http://apps.who.int/iris/
4. A Brief History of La Leche League International. At: www.llli.org/
5. Reiger, Kerreen M.Our bodies, our babies: The forgotten
women’s movement, Melbourne University Press, Melbourne,
6. Australian National Breastfeeding Strategy 2010–2015.
Australian Health Ministers’ Conference. 2009. At: www.health.
7. Freedman M. At: www.mamamia.com.au/parenting/lets-chill-
9. Freedman M. At: www.mamamia.com.au/parenting/australian-
10. Pediatrics 2013; online 13 May, 2013.
13. The Baby-friendly Hospital Initiative. World Health organization.
There are basic questions pharmacists can ask people
purchasing infant formula to help ensure they get the most
appropriate product and receive professional advice:
Have you used this before?
How old is the baby?
What are the circumstances for needing formula?
Is the mother breastfeeding too?
Has the mother been told about weaning from the
breast to avoid infection?
Are you aware of sterilising procedures?
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