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Table 2 European Population-based data sources with data on breastfeeding plus medicines use during pregnancy plus neurodevelopment

From: Breastfeeding, pregnancy, medicines, neurodevelopment, and population databases: the information desert

Country Data sources (breastfeeding data sources italicised) Neurodevelopmental measurement available Breastfeeding information categories as they appear in the data source Pregnancies per year (1,000 s) Birth years with breastfeeding plus neurodevelopment data
Finland Care Register for Health Care, Primary Health Care, Drugs and Pregnancy Database, Finnish Medical Birth Register, CA registry ICD codes recorded in outpatient or GP care Assessed and recorded by midwives at discharge or 7 days postpartum
Categories: exclusive breastfeeding, partial breastfeeding, ‘artificial milk’ only
50 2017-
France (Haute-Garonne) EFEMERIS* database (pregnant women and their children) Certificates completed at 9 and 24 months by a general practitioner or a paediatrician – include 14 items designed to detect children at risk of psychomotor development abnormalities Self-report, recorded on health certificates completed during mandatory medical examinations at 8 days, 9 months and 24 months 10 mid 2004-
POMME databases (breastfeeding data to 24 months) As above plus
Medicines and health care reimbursements
‘any’ breastfeeding (Yes/No), duration of breastfeeding (in weeks), and duration of exclusive breastfeeding (weeks)
(Both databases)
18.5 Follow up of birth years:
mid 2010 to mid 2011 + mid 2015 to mid 2016
Italy – Tuscany Mental health services, birth registry, medicines dispensed in community pharmacies, and hospital pharmacies for outpatient use Outpatient and mental health service ICD codes Hospital records documenting how the new-born was fed during the hospital stay
Categories: Only breast milk, breast milk with the addition of water or liquids other than milk, breast milk and infant formula, infant formula only
30 2010-
UK- Scotland Child Health Systems, Programme – Pre-School, Child Health Systems Programme – School, Support Needs System, Maternity hospital discharge records (including delivery records), Prescribing Information System Children registered on the Support Needs System, Child health developmental examinations Health visitors’ records of self-report at 10 days, 6 weeks and 13 months. Categories: breast milk only, fed formula milk only, or fed both breast and formula milk 53 2013-
UK – Wales In-patient and out-patient records, Primary Care GP data†, National Community Child Health Database, National Pupil Database Wales, congenital anomaly registry ICD/Read codes, child health developmental examinations, special education needs, and educational attainment from 7 to 16 years Health visitors’ records of self-report:
at birth and 6–8 weeks
at 6 and 12 months
Categories: ‘any’ breastfeeding (yes/no)
33 2005-
  1. Information was collated in January 2021. Data sources were identified by contacting representatives of all countries in Europe and searching the literature to compile the Fair Data Catalogue for the Conception project, as described:. To identify data sources containing all three variables, the breastfeeding and neurodevelopmental data source lists were cross-referenced and data were discussed with the data access providers
  2. ICD International classification of disease, as issued by the World Health Organisation (WHO)
  3. We use ‘neurodevelopment’ as an umbrella term for cognitive, social, motor and behavioural development. How these data can be usefully combined and standardised is being investigated
  4. Exclusive breastfeeding is as defined by the WHO (2008): Infant receives only breast milk from his/her mother or a wet nurse, or expressed breast milk via tube, cup or syringe, and no other liquids or solids with the exception of drops or syrups consisting of vitamins, mineral supplements or medicine. (WHO 2008 Indicators for Assessing Infant and Young Child Feeding Practices – Part I: Definitions. Conclusions of a Consensus Meeting Held 6–8 November 2007 in Washington D.C.;jsessionid=DB32B0C8C42A0F61174ECAF42D8FC8FD?sequence=1)
  5. Where breastfeeding is self-reported at certain time-points, the duration of ‘breastmilk only’ or ‘any breastfeeding’ is taken as ‘from birth’. We acknowledge this may introduce imprecision
  6. *EFEMERIS covers the 80% of the population covered by the state-controlled French Health Insurance [22]
  7. In Wales, ~ 80% primary care providers voluntarily supply medicines data to the databank. Any selection bias is due to healthcare providers, not subjects. All pregnancies identified can be followed for life, unless the individual leaves the country
  8. Papers relating medicines use to breastfeeding are available for France [23] and Wales [24, 25]