Share

cover art for Evidence-based prescribing and medication safety in breastfeeding with pharmacist Rachel Pilgrim

Clinical Update

Evidence-based prescribing and medication safety in breastfeeding with pharmacist Rachel Pilgrim

Season 6, Ep. 11

In this episode of the Clinical Update podcast, MIMS Learning deputy editor Rhiannon talks to pharmacist Rachel Pilgrim about the impact of medication on breastfeeding cessation. Rachel describes how her own experience inspired her research into this area, and discusses how primary care can support patients with consistent, evidence-based information (and where to find this):


‘Medicines shouldn't be a barrier to breastfeeding but ... uncertainty, conflicting guidelines, conservative licensing, and probably patchy training as well, creates a huge amount for prescribers and mums to navigate.’


The discussion covers the public health importance of breastfeeding, physiological factors influencing drug transfer into breast milk, and the relationship between health inequalities and breastfeeding. 


Educational objectives


After listening to this podcast, healthcare professionals should be better able to:


  • Explain the public health importance of breastfeeding and recall the WHO recommendation for breastfeeding to 2 years and beyond
  • Note UK breastfeeding rates and how these compare with global statistics
  • Identify physiological factors that influence drug transfer into breast milk
  • Understand the relationship between health inequalities and breastfeeding


You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.


Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.


Key prescribing resources:


MIMS Learning

Register for a FREE account

More episodes

View all episodes

  • Space-Comm Expo: jamming, spoofing and farming

    20:56|
    What did the Space-Comm Expo conference and exhibition tell us about connecting space and wider business? How does this manifest as tech connectivity in telecoms and why do farmers care about that? What did we learn about the benefits of extreme cold in manufacturing laboratories and why do pharmas care about that? How vulnerable are global logistics to the spoofing of navigation signals? And why is the UK government centralising space strategy in the Department for Science, Innovation and Technology? Join Alice and Jonners as they reflect on the UK space sector’s largest trade event and the “energy, diversity and …sheer scope of what this industry has to offer”. Contributors:Alice Bunn, President of UKspace Dr Alice Bunn OBE FIMechE FRAeS CEng | LinkedInUKspace: Overview | LinkedIn Jonathan Daves, The Karman LineJonathan Daves | LinkedIn Subscribe to The Karman LineApple: https://podcasts.apple.com/ca/podcast/the-k%C3%A1rm%C3%A1n-line/id1876605462Spotify: https://open.spotify.com/show/3qED4CgdRDxfKKzYNKZCIH?si=lZ-I4a19SPGLAJL-dHi4DQYouTube: https://www.youtube.com/@TheKármánLineUKKey topics covered:Space-Comm Expo, London, March 2026Conference overviewSector integrationInsuranceCustomer utilityGovernment roleFuture outlook Technological advancements· Telecoms· Manufacturing Defence and security· Satellite capabilities· Current threats
  • 12. Diabetes risk factors, diagnosis, management, and complications

    16:38||Season 6, Ep. 12
    Primary care professionals have broadly welcomed the 2026 update to the NICE type 2 diabetes guidelines because it focuses on reducing the risk of diabetes-related complications, such as cardiovascular disease, as well as optimising glycaemic control. With this in mind, MIMS Learning medical editors Dawn and Sangeeta take a deep dive into the extensive diabetes content available on MIMS Learning. They look at how both latent autoimmune diabetes (LADA) and type 3c diabetes can be misdiagnosed as type 2 diabetes, risk factors for diabetes (such as obesity), and multiple diabetes-related complications (including cardio-renal-metabolic disease).Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Describe the different types of diabetes that might present in primary careDiscuss how ethnicity can affect both the risk of diabetes and the risk of diabetes-related complicationsReview the overlap in management of type 2 diabetes, heart failure, and chronic kidney diseaseRecall potential diabetes-related complications, including cardio-renal-metabolic disease and foot ulcers. You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.MIMS LearningRegister for a FREE accountCardio-renal-metabolic disease: clinical reviewCase study: latent autoimmune diabetes in adultsCKD podcourse with Dr Andrew Frankel, part 1: diagnosis and classificationDiabetes-related skin conditions and diseasesIdentifying and managing young-onset type 2 diabetesPodcast: Dr Patrick Holmes on identifying type 3c diabetes in primary careType 2 diabetes in South Asian and African-Caribbean populationsUnderstanding painful diabetic neuropathyOther resourcesPetition launched for routine diabetes testing after death of two-year-old wrongly diagnosed with tonsilitis
  • 10. Podcast: infant and child nutrition problems encountered in primary care

    16:06||Season 6, Ep. 10
    This episode of the Clinical Update podcast discusses the range of feeding, nutritional and gastroenterology problems a GP might encounter in a paediatric population, including gastro-oesophageal reflux disease (GORD), cow’s milk allergy (CMA), and malnutrition.The podcast discusses learning points for primary care professionals around infant feeding and childhood nutrition. It also looks at the stepwise management of GORD, clinical diagnosis of CMA, and the hidden prevalence of malnutrition. How to accurately plot faltering growth and when to trigger specialist referrals or safeguarding protocols is also highlighted.You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to: Differentiate between gastro-oesophageal reflux and GORD Identify red flag symptoms in vomiting infants that might indicate urgent secondary care referralRecognise the clinical presentation of IgE- and non-IgE-mediated cow’s milk allergyUnderstand the impact of ultra-processed foods on malnutrition in children with obesityApply UK-WHO growth chart thresholds to accurately identify significant faltering growthRecall the medical and behavioural differentials for suboptimal weight gain in infantsEvaluate the role of multidisciplinary teams in managing avoidant-restrictive food intake disorder (ARFID) and sensory aversionsUnderstand the GP’s professional responsibility regarding safeguarding in cases of growth failurePlease note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.PresentersSangeeta Krishnan, medical editorPat Anderson, editorMIMS LearningTwickenhamUK Episode produced by Jude OwenMIMS Learning resourcesMalnutrition in childrenNICE guidance on GORD in childrenFeeding difficulties in infantsFaltering growthPodcast: Dr Joy Shacklock on child safeguarding in primary care
  • 9. Diagnosing atrial fibrillation and preventing stroke with Dr Chris Arden

    30:18||Season 6, Ep. 9
    Atrial fibrillation (AF) can be asymptomatic and, sometimes, the condition is only identified when a person has had an AF-related stroke. For this reason, according to GP Dr Chris Arden, ‘we need to be far more proactive and more opportunistic’ about identifying AF in primary care. This could involve performing pulse checks at flu clinics or chronic disease clinics, focusing on elderly patients given they are most at risk of developing AF.Dr Chris Arden talks to Dawn Liz Powell, in this Clinical Update podcast episode, about the diagnosis and management of AF in primary care. He discusses the pros and cons of single-lead ECGs, how to mitigate the risk of bleeding in people on direct oral anticoagulants (DOACs), and when to refer.Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Review the opportunities for AF case findingReflect on the role of lifestyle factors including alcohol consumption in triggering AF in susceptible individualsDiscuss the emerging role of single-lead ECG technologies identifying AFHow to mitigate the risk of bleeding in people on DOACsRecognise the importance of continuing anticoagulation in frail, older peopleYou can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.MIMS Learning Live Digital: 9–12 March 2026Register for FREE MIMS LearningRegister for a FREE accountAtrial fibrillation: diagnosis, case-finding and assessmentAtrial fibrillation: the ABC approach to managementConfidence in Obesity CareStroke: clinical reviewMIMSDirect oral anticoagulants for the prevention of stroke
  • Why the business of space is everyone’s business

    43:05|
    As of 2026, the UK space industry is a significant and strategic driver of the national economy, contributing over £19 billion in revenue and supporting tens of thousands of high-skilled jobs. Satellite-based services and data underpin roughly 18% of UK GDP, equivalent to approximately £454 billion of the wider economy. And the sector is growing exponentially.But this is just the tip of the iceberg. For the space industry to fully realise its potential it needs more of the right people to understand what’s happening and get involved. People like policy makers, investors, regulators, planners, communicators, lawyers and consultants.Dr Alice Bunn, the president of UK Space, and her panel of guests, Sam Alden co-CEO of Space Solar, Nick Shave managing director of Astroscale and Anushka Sharma founder of Naaut, discuss the surprising, awe inspiring business of space and make the compelling case for why more companies and investors should get involved. Contributors:Host:Alice Bunn, President of UKspace Dr Alice Bunn OBE FIMechE FRAeS CEng | LinkedInUKspace: Overview | LinkedInGuests:Nick Shave, Managing Director of AstroscaleNick Shave FRAeS | LinkedInAstroscale: Overview | LinkedInSam Adlen, CEO of Space SolarSam Adlen | LinkedInSpace Solar: Overview | LinkedInAnushka Sharma, founder of NaautAnushka Sharma | LinkedInNaaut: About | LinkedInKey topics covered:Impact of Space on Everyday LifePractical ApplicationsEnvironmental MonitoringGlobal SecuritySustainability and Innovation in OrbitSpace DebrisManufacturing in MicrogravitySpace-Based Solar PowerEconomic and Regulatory LandscapeCost ReductionInvestment and FinanceRegulation and PolicyThe Future of Space ExplorationNew PlatformsAcademic Contribution
  • 8. Podcast: mental health in primary care case studies

    14:04||Season 6, Ep. 8
    Mental healthcare is a vital part of general practice. In this episode of the Clinical Update podcast, MIMS Learning editor Pat Anderson and medical editor Sangeeta Krishnan discuss case studies that prompt GPs to reflect on their practice.0.5 CPD hoursThis podcast draws on the mental health learning plan, featuring modules written by Professor Carolyn Chew-Graham, to highlight important aspects of mental healthcare in general practice. It discusses learning from the plan around the mental health needs of patients with cancer, talking openly about suicide risk, and understanding why patients do not attend primary care appointments.NB: This podcast contains discussion of suicide and self-harm, and how GPs can help patients and colleagues to stay safe. The Samaritans helpline is 116 123.You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to: Recall when risk of self-harm or suicide is heightened following a diagnosis of cancerConduct effective cancer care reviews that encourage exploration of moodUnderstand the concepts of ‘scanxiety’ and healthcare-related anxiety after a cancer diagnosisTalk openly about suicide risk with patients and colleaguesUnderstand and address barriers to attendance at healthcare appointmentsPlease note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.PresentersPat Anderson, editorSangeeta Krishnan, medical editorMIMS LearningTwickenhamUK Episode produced by Jude OwenMIMS Learning resourcesAdult mental health learning planCase series: the psychological effects of cancerExploring the risk of self-harm and suicide in primary careWhy people miss medical appointments and how to support themPodcast: interviews with patients and clinical nurse specialists on breast cancer diagnosis and follow-up
  • 7. Shared decision-making and personalised care in general practice, ,with Dr Sam Finnikin

    27:11||Season 6, Ep. 7
    In this episode of the Clinical Update podcast, academic GP Dr Sam Finnikin speaks to MIMS Learning’s medical editor Sangeeta Krishnan about the essential role of shared decision-making  in modern primary care. Sam talks about why shared decision-making is a legal and ethical responsibility, and how GPs can effectively integrate it into the standard 10-minute consultation. They also discuss the unique challenges of polypharmacy, the art of ‘not doing’ as an active clinical choice, and how to communicate complex risks to patients in a way they can best understand.Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Evaluate the role of shared decision making as a fundamental, non-optional approach to every clinical decision.Implement strategies to achieve shared decision-making within 10-minute consultations by leveraging continuity of care and splitting decisions over time.Apply evidence-based medicine with care to individual patients, particularly those with multimorbidity and polypharmacy who are often excluded from research populations.Understand the concept of ‘not doing’ (active watchful waiting) and how it can improve healthcare efficiency and patient outcomes.Communicate risks effectively using absolute numbers, natural frequencies, and positive/negative framing to aid patient deliberation.Encourage patient autonomy while providing tailored recommendations that incorporate a patient’s individual values and preferences. You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.MIMS LearningRegister for a FREE accountStrategies for the safe deprescribing of antidepressantsCase series: polypharmacy in older people with mental health conditionsPolypharmacy in a patient with dementia: nursing home case studyDr Pipin Singh on best care for nursing home patientsMultiple morbidity: nursing home case studyGuidance update: latest NICE guidelines on hypertensionDepression: clinical review
  • 6. Insomnia, obstructive sleep apnoea, and night sweats

    17:08||Season 6, Ep. 6
    Insomnia refers to the persistent difficulty with getting to sleep, maintaining sleep, or quality of sleep that occurs despite adequate opportunity and circumstances for sleep and results in impaired daytime functioning. It can often be a sign of an underlying psychological or physical condition.In this episode of the Clinical Update podcast, MIMS Learning editors Dawn and Pat review how insomnia should be assessed in primary care and how it should be managed. They also discuss related sleep disorders, such as obstructive sleep apnoea (OSA) and night sweats.Given sleep disorders can lead to sleep deprivation and daytime sleepiness, the editors also look at DVLA regulations on driving with a sleep disorder.Educational objectivesAfter listening to this podcast, healthcare professionals should be more able to:Discuss the types of insomniaRecall pharmacological options for treating insomniaReview the risk factors for OSAAppreciate the role of the GP in supporting patients with suspected OSAInvestigate the possible causes of night sweatsYou can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.MIMS LearningRegister for a free MIMS Learning accountAdult obstructive sleep apnoea syndrome: clinical reviewConfidence in Obesity CareInsomnia - red flag symptomsNight sweats - red flag symptoms