The MHRA has issued a warning about the risk of skeletal adverse effects in the neonate following prolonged or repeated use of magnesium sulfate in pregnancy. Maternal administration of magnesium sulfate for longer than 5 7 days in pregnancy has been associated with skeletal adverse effects and hypocalcaemia and hypermagnesemia in neonates. If use of magnesium sulfate in pregnancy is prolonged or repeated, consider monitoring of neonates for abnormal calcium and magnesium levels and skeletal adverse effects. In 2009, the MHRA issued a drug safety update on ACE inhibitors and angiotensin II receptor antagonists: recommendations on how to use during breastfeeding, and a subsequent clarification was issued in 2014. This clarification states: 'although ACE inhibitors and angiotensin II receptor antagonists are generally not recommended for use by breastfeeding mothers, they are not absolutely contraindicated. Healthcare professionals may prescribe these medicines during breastfeeding if they consider that this treatment is essential for the lactating mother. In mothers who are breastfeeding older infants, the use of captopril, enalapril, or quinapril may be considered if an ACE inhibitor is necessary for the mother. Careful follow-up of the infant for possible signs of hypotension is recommended'. Recommendations for research As part of the 2019 update, the guideline committee made 6 research recommendations on the management of pregnancy with chronic hypertension, pre-eclampsia, fetal monitoring, the use of antihypertensives in breastfeeding and advice and follow-up. A research recommendation from the 2010 guideline which was superseded by these new research recommendations was deleted, and 3 research recommendations where research was now underway or had been completed were also deleted. 