Last update Aug. 19, 2021
Very Low Risk
Short-acting benzodiazepine. Indicated for the treatment of acute seizures, insomnia and pre-surgical sedation and induction of anesthesia.
Oral or intravenous administration, generally in a single dose. In insomnia, a single daily dose.
It is excreted in breast milk in undetectable or clinically insignificant amounts (Nitsun 2006, Koitabashi 1997, Matheson 1990) and no problems have been observed in infants whose mothers were taking it, including during the neonatal period (Kelly 2012).
The administration of a dose of midazolam after caesarean section does not interfere with the initiation and duration of lactation (Suppa 2012).
Various medical societies and expert consensus consider the use of this medication safe during breastfeeding. Breastfeeding can be resumed as soon as the mother is awake and healthy. (Briggs 2017, Hale 2017 p655, Reece 2017, Schaefer 2007 p634, Nitsun 2006, Spigset 1994, Lee 1993).
It does not seem justifiable to wait 4 hours to breastfeed after the last dose of midazolam as recommended by some authors (Shergill 2012, Vargo 2012, Matheson 1990).
The occasional and low-dose use of benzodiazepines is compatible with breastfeeding (Kelly 2012, Rubin 2004, Iqbal 2002, Hägg 2000, McElhatton 1994, Lee 1993, Kanto 1982).
Choose short-acting benzodiazepines and use the lowest effective dose (Rowe 2013), especially during the neonatal period and in prematurity, as they can accumulate in the infant during chronic use (Sachs 2013).
It is advisable to monitor drowsiness and adequate feeding of the infant.
Bed-sharing with the baby is not recommended if this medicine is being taken due to increased risk of suffocation or sudden infant death (UNICEF 2018, 2017, 2014 and 2013, Landa 2012, ABM 2008, UNICEF 2006).
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2012 of United States of America
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