When a woman who is breastfeeding develops an infection or a flare of a chronic condition, they face a decision that sounds simple but rarely is: should they take the medication to treat their condition?

As a pharmacist and researcher, I field this question frequently, and the people asking it are usually doing so with far less information than what is available. A study my colleagues and I recently published in the International Breastfeeding Journal aimed to understand more about how parents and health-care providers navigate this question.

We surveyed 165 breastfeeding parents and 47 health-care providers across Canada about how they make decisions on medication use during lactation. More than half of the parents told us they found these decisions difficult. Close to half said they worried about what could go wrong.

What is concerning is that among parents who had to make a medication decision, more than half deliberately chose not to start a medication while breastfeeding and almost a quarter stopped breastfeeding in order to take one. These are meaningful trade-offs — between a parent’s own health and how they feed their child. Our findings suggest many people are making them without enough support.

When we asked parents and providers what made these decisions hardest, both groups ranked a lack of information about the options, benefits and risks of medications as the number one barrier. For birth parents, the next concern was not knowing which resources to trust. For providers, it was parents’ fear and anxiety, followed by conflicting information from other clinicians.

These findings suggest that clinicians and parents alike share that there........

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