Is Diazepam safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Diazepam. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
Three infants were breastfed from birth while their mothers were receiving diazepam 10 mg 3 times daily. The authors noticed no lethargy or hypoventilation in the infants during the 6-day observation period. The authors expressed concern that nordiazepam may compete with bilirubin for hepatic glucuronide conjugation in the neonate.[ 2 ] A nursing mother was given diazepam 10 mg orally 3 times a day beginning on day 5 postpartum. Weight loss, lethargy and an EEG consistent with sedative effect in her 8-day-old was probably caused by diazepam or its metabolites in breastmilk.[ 8 ] Of 8 infants breastfed from birth during maternal diazepam therapy (dosages unspecified), 3 had mild jaundice during the first few days postpartum, although this was not thought by the authors to be unusual.[ 9 ] Sedation was reported in the breastfed newborn infant of a mother taking oral diazepam 6 to 10 mg daily if the infant was nursed within a few hours of a dose, but not if she nursed 8 or more hours after a dose. Infant sedation was probably caused by diazepam and its major metabolite in breastmilk.[ 5 ] In a telephone follow-up study, 124 mothers who took a benzodiazepine while nursing reported whether their infants had any signs of sedation. About 10% of mothers took diazepam while breastfeeding and none reported sedation in her infant.[ 10 ] In a longitudinal study of women taking medications during breastfeeding, some mothers who were taking diazepam reported discontinuing breastfeeding because of drowsiness in their breastfed infants.[ 11 ] A retrospective chart review of 298 mothers and infants born at 37 weeks or beyond was conducted to determine the effects of ketamine and diazepam on breastfed infants after maternal tubal ligation surgery. Surgery occurred on a median of day 2 (range 1 to 6) postpartum. Most infants were fully breastfed, with breastfeeding resumed 2 to 4 hours after the procedure. Infants of mothers who received a dosage of diazepam of 0.1 mg/kg or greater du
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Diazepam is metabolized to the active metabolites nordiazepam (desmethyldiazepam) and temazepam, which are in turn metabolized to the active metabolite oxazepam. Maternal Levels . Three patients were given diazepam 10 mg orally 3 times daily for the 6 days after delivery. Average milk levels of diazepam plus nordiazepam were 79 mcg/L after 4 days (total diazepam dosage130 mg) and 130 mcg/L after 6 days (total diazepam dosage 190 mg). Oxazepam was not detected.[ 2 ] In a 1-day postpartum woman, a colostrum diazepam level of 100 mcg/L milk level was found 25 hours after the last of 3 intravenous 5 mg doses of diazepam given over a 4-hour period.[ 3 ] Four women were given diazepam 10 mg at bedtime for 6 days, beginning 3 days postpartum. Each had also received intravenous diazepam 20 mg immediately prior to delivery. Milk levels were collected 9.25 and 23.5 hours after each dose from days 3 to 9 postpartum. Milk levels of diazepam and nordiazepam did not differ markedly between the collection times and ranged from 17 to 39 mcg/L for diazepam and 19 to 52 mcg/L for nordiazepam.[ 4 ] Breastmilk levels of 27 to 164 mcg/L of diazepam plus nordiazepam were found at various times between 9 days and 3.5 months postpartum during an irregular regimen of 6 to 10 mg daily of oral diazepam in 1 woman.[ 5 ] A woman who had been abusing benzodiazepines was taking diazepam 80 mg and oxazepam 30 mg daily at the time of study. Milk samples were taken before and after the morning feeding following the morning dose of diazepam during a 30-day tapering dosage regimen. The average of the pre- and post-feed diazepam milk levels were 185 and 307 mcg/L, and average nordiazepam milk levels were 124 and 141 mcg/L on days 14 and 15 during maternal intake of diazepam 40 mg daily. The average of the pre- and post-feed diazepam milk levels were 200 and 158 mcg/L, and average nordiazepam milk levels were 140 and 85 mcg/L on days 23 and 25 during maternal intake of diazepam 30 mg daily. The average
Alternatives LactMed lists
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.