Medicine use during breastfeeding in Uganda: stakeholder perspectives on barriers and facilitators

Breastfeeding supports infant health, yet medicine use during this period is often influenced by limited safety data, cultural beliefs, and weak regulatory guidance. This study highlights how these factors, along with partner influence, contribute to uncertainty and reliance on informal advice, emphasizing the need for clear guidelines and better communication to support safe medicine use.

This exploratory qualitative study was conducted between January and April 2024, involving twelve breastfeeding women, seven of their partners, ten healthcare providers, and five representatives from the National Drug Authority in Uganda. Data were collected through in-depth interviews with breastfeeding women and their partners, while key informant interviews were conducted with healthcare providers and regulatory officials. Thematic analysis was employed to analyze the data, identifying recurring codes that were systematically organized into subthemes and overarching themes.

Four key themes were identified concerning perspectives on medicine use during breastfeeding. First, healthcare providers and regulatory personnel showed varying levels of knowledge of medicine use during breastfeeding, relying on external resources due to uncertainty, while women identified healthcare providers as their primary and most trusted source of information regarding medicine use. Facilitators included trust in healthcare providers, support from partners and family, access to reliable safety information, strengthening pharmacovigilance systems, and conducting drug safety studies. The role of partners in offering financial and emotional support and encouraging medicine adherence was acknowledged. Barriers to medication use during breastfeeding included poor communication and inadequate guidance from healthcare providers, stigma, and concerns about risks from the medicines to the infant. Additionally, unclear drug labeling, inaccessibility of information, and ethical concerns about including breastfeeding women in studies hindered informed decision-making. Recommendations emphasized improving health education, using reliable resources, prescribing safer drugs, timing breastfeeding to minimize medicine risks, and considering non-hormonal contraceptive options to prevent reduced breast milk supply.

The study highlights the critical need for improved communication, guidance, and access to reliable information regarding medicine use during breastfeeding. It emphasizes the importance of healthcare provider education, partner involvement, and evidence-based guidelines to support informed decision-making.