Medication risk categorization systems such as the well-established Hale’s Lactation Risk Categories (Hale’s Medications and Mothers’ Milk 2026), provide a standard­ized framework for evaluating medication safety during breastfeeding based on pharmacokinetic parameters. Other recently published scoring systems consider additional non-pharmacokinetic parameters such as the number of exposed infants reported in the literature and prevalence of reported adverse events in calculating a safety score (Uguz 2021). These various category risk systems provide useful guid­ance and reduce complex information into a simplied rating score which is cer­tainly user-friendly for clinicians. However, they do not take into consideration other important individual variables which are essential for nuanced clinical deci­sion making—such as infant age and health condition, maternal illness severity, and risks of untreated condition—are not fully captured in these standardized frame­works. Furthermore, inconsistency between these different systems can create con­fusion, as the same medication may receive different risk categorizations depending on which framework is consulted. Given these constraints, clinicians should view these risk categories as merely one element within a more comprehensive decision­making framework rather than the sole determinant when advising breastfeeding mothers about medication use.