Last update: May 4, 2019
Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
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It is a long-acting benzodiazepine with anticonvulsant, sedative, muscle relaxant and anxiolytic actions.
It is metabolized into desmethyldiazepam and temazepam and, finally, to oxazepam.
Oral, rectal and parenteral administration 2 to 4 times a day.
It is excreted in breast milk in an amount that can be significant (Borgatta 1997, Dusci 1990, Wesson 1985, Brandt 1976, Cole 1975, Erkkola 1972, Patrick 1972).
Plasma levels of infants have been measured (Erkkola 1972), more than 5 times lower than the corresponding maternal ones (Wesson 1985).
Some authors have not observed problems in infants whose mothers took it (Kelly2012, Erkkola 1972); others have published sedation and poor suction réflex in the infant (Wesson 1985, Patrick 1972) especially with repeated or high doses and in the neonatal period (Davanzo 2013).
The occasional use and low doses of benzodiazepines are compatible with breastfeeding (Kelly 2012, Rubin 2004, Iqbal 2002, WHO 2002, Hägg 2000, McElhatton 1994, Lee 1993, Kanto 1982).
It is advisable to choose a short-acting benzodiazepine and minimal effective dose as possible (Rowe 2013, WHO 2002), especially in the neonatal period and in case of prematurity because they can accumulate in the infant during chronic use (Davanzo 2013, Sachs 2013, Amir 2011).
It is advisable to monitor drowsiness and adequate feeding of the infant.
It is not recommended to share a bed (co-sleeping, bed-sharing) with the baby if this drug is being taken, due to increased risk of asphyxia or sudden infant death (UNICEF UK 2018, 2017, 2014 and 2013, Landa 2012, ABM 2008, UNICEF UK 2006).
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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