Dr. Hale's idea of classification of a drug is a very good idea, but it
needs some refinement.  L3 (moderately safe) includes many drugs which are
obviously very safe. The reason they are not included in L1 or 2 is that
there are no studies which support the theoretical reasons why these drugs
would be safe.  Thus, though interferon is too big to get into the milk and
cannot, thus possibly cause harm to the baby, it is classified as L3.
Unfortunately, too many physicians will look at that (moderately safe) and
say, "Moderately safe is just not safe enough".  That is why any tool needs
to be used properly.  Too many people will look just at the classification
without looking at the pharmacokinetics.

Jack Newman, MD, FRCPC

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