Drug Dilemmas: Navigating Pharmacology for Expectant and Nursing Mothers

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It’s easy for healthcare providers to feel overwhelmed by medication safety during pregnancy and breastfeeding. In this episode, Cara and Missi take this complex topic and make it simple.

They start by highlighting a common issue: many clinicians still use the outdated FDA risk categories (A, B, C, D, X), which were replaced in 2015 by the more detailed Pregnancy and Lactation Labeling Rule (PLLR). The hosts explain how pregnancy changes a person’s body and how this affects medication, from blood volume to heart rate. They also cover specific medications to be cautious with, like ACE inhibitors and statins. When it comes to breastfeeding, the discussion turns to lactation risk categories (L1–L5) and practical factors like timing and a baby’s age as well as what's really important for nursing moms.

This episode covers common clinical scenarios and provides clear guidance on safe medication options for both pregnant and breastfeeding patients while providing valuable resources for students and practicing midwives. This episode turns an intimidating topic into a manageable framework for confident prescribing.

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