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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

Categories:

‘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-

2015-

  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:. https://www.imi-conception.eu/wp-content/uploads/2019/09/ConcePTION_D1.1_spreadsheet-containing-all-additional-data-sources-for-the-ConcePTION-Data-Source-Catalogue.pdf 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. https://apps.who.int/iris/bitstream/handle/10665/43895/9789241596664_eng.pdf;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]
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International Breastfeeding Journal

ISSN: 1746-4358