SickKids winds down its Motherisk Helplines

TORONTO – The Hospital for Sick Children has announced the closure of the Motherisk Helplines. The decision follows years of declining grant funding leading to staff reductions, as well as unsuccessful efforts to secure an alternative host for the program.

The Motherisk Program was created at The Hospital for Sick Children (SickKids) in 1985. The program’s services addressed the lack of availability of up-to-date information about the risk and safety of medications and other exposures during pregnancy and breastfeeding.

As such, the Motherisk Helplines were popular with family physicians and obstetricians, as well as women during pregnancy and while breastfeeding. The number of calls to the Helplines has remained high, and closing the service was not an easy decision, a hospital news release said.

“Without sustainable, secure funding and absent an alternative, reputable organization to host and fund the Helplines, SickKids has made the difficult decision to close the program,” said Dr. David Naylor (pictured), SickKids interim president and CEO. “SickKids also believes the program needs to be reinvented, set up with a clear national mandate, and tied more closely to the obstetrics and primary care communities. Physicians and scientists on our staff would be very happy to work with any new host organizations.”

The decision was based on three factors. First, the initiation of this program reflected the research interests and expertise of academic physicians on staff at the time. The Motherisk Helplines were funded through various external grants and donations. It was neither Ministry mandated, nor provincially funded, and thus its closure is unrelated to provincial funding.

Over the last three years, those grants and donations have been reduced to zero. The Hospital does not believe it is appropriate to continue cross-subsidizing this service from an operating budget focused on complex care for some of the sickest children in Ontario and from across Canada.

Second, the difficulty in seeking private support for the program reflected adverse publicity arising from concerns about the quality of work carried out by a hair analysis laboratory that also carried the Motherisk name. Consideration was given to re-naming and re-branding the Helplines. However, questions quickly arose as to whether this service was best hosted at a paediatric hospital.

A more logical alternative would be for the Helplines to be hosted at a hospital with substantial activity in caring for women during pregnancy and in the postnatal period.

Ideally, such a service would be tied to national organizations of specialists in disciplines such as family medicine and obstetrics and gynaecology. We have explored some of these possibilities, and have emphasized that SickKids physicians and scientists would be pleased to continue to provide input on clinical pharmacology and toxicology in any transition.

The challenge is that a major organizational and fundraising effort would be required, and the lack of an identifiable and consistent source of external funding remains a hurdle.

Among the considerations here is that the complexity of issues in this realm is steadily growing. Physicians are prescribing powerful new drugs based in modern molecular biology, and individual variation in drug metabolism has become clearer as the discipline of pharmacogenomics has grown. To remain relevant and cutting-edge, this program would need financial support above its previous peak levels.

Third and finally, additional resources are available. Individuals with inquiries about medications and other exposures during pregnancy and while breastfeeding can contact their healthcare providers.

The US-based MotherToBaby website offers evidence-based information for mothers, healthcare professionals and members of the general public. (Due to high volumes, MotherToBaby is unable to accommodate calls from Canada at this time.)

The Organization of Teratology Information Specialists (OTIS) is the professional scientific society made up of the experts that provide the MotherToBaby service and do research in this field. OTIS and its information service, MotherToBaby, are recommended by many agencies including the Centers for Disease Control and Prevention (CDC).

More than 100,000 women and their healthcare providers seek information about birth defect prevention from OTIS and MotherToBaby every year.

SickKids is still accepting referrals to the Motherisk Clinic from healthcare providers. The Motherisk Clinic is a specialized referral-only service that assesses the safety of medications and/or substances consumed by pregnant or nursing women and the potential effects on their babies. Healthcare providers can continue to send referrals via EpicCareLink.

About The Hospital for Sick Children (SickKids)
The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric healthcare institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures healthcare professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is a founding member of Kids Health Alliance, a network of partners working to create a high quality, consistent and coordinated approach to pediatric health care that is centred around children, youth and their families. SickKids is proud of its vision for Healthier Children. A Better World.