It is true that there is little there. In facing a situation when a mother
is about to go on a drug about which we know little, here is what I would
do.

1. Look at the possibility of another drug which is definitely compatible
with breastfeeding.
2. If this is not possible, assume that breastfeeding is okay, unless there
is *good* evidence that it is not. Breastfeeding is too important for the
health of the baby and mother to give up because we don't know enough about
the drug. We know plenty about formula.
3. Observe the baby carefully, do milk levels and if possible baby blood
levels of the drug.
4. Publish, so that we do get information.
5. If there is a problem with the drug, look for another one, just as we
would if there were a *maternal* problem with the drug.

Jack Newman, MD, FRCPC

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