Managing Allergies During Lactation: Patterns of Medication Use and Risk Assessment Among Breastfeeding Women

In recent years, an increasing prevalence of allergic diseases and, consequently, the use of medication to alleviate allergy symptoms was reported, while medication safety remains an understudied concern in breastfeeding women. This study aimed to determine the prevalence of allergic conditions among breastfeeding women, assess the utilization and safety of medications used for symptom relief, and describe pharmacist interventions delivered in community pharmacies.

A retrospective cohort study was conducted in community pharmacies as part of the national "Mama Friendly Pharmacy" initiative. Sociodemographic, clinical, and pharmacotherapy data were collected using structured questionnaires. Medication safety during lactation was assessed according to the e-lactancia database. The descriptive and statistical analyses were carried out using SPSS software.

Among 515 breastfeeding women (mean age 30.9 ± 5.1 years), allergy was the most common medical condition (12.2%). Breastfeeding difficulties were reported by 35.1% of participants and were not significantly associated with allergies (p = 0.084). Women with allergies were less likely to use systemic anti-infectives and more likely to use respiratory medications, predominantly second-generation antihistamines (both p < 0.001). Among women with allergies, 57.1% received pharmacological treatment, and all prescribed medications were classified as safe or fairly safe during lactation, with relative infant doses below 10%. Pharmacists documented interventions in 41.3% of symptomatic women, including symptom management, safer medication substitution, breastfeeding-related administration advice, and infant monitoring recommendations.

Allergies were common during breastfeeding, reinforcing their growing global burden. Pharmacist-led counseling contributes to evidence-based medication use and optimization of pharmacotherapy while maintaining infant safety.