Last update April 24, 2022
Long-acting benzodiazepine with anticonvulsant, sedative, muscle relaxant and anxiolytic actions. It is metabolized to desmethyldiazepam (nordazepam), temazepam, and oxazepam. Oral, rectal, vaginal and parenteral administration 2 to 4 times a day.
It is excreted in milk in an amount that may be clinically significant. (Borgatta 1997, Dusci 1990, Wesson 1985, Brandt 1976, Cole 1975, Erkkola 1972, Patrick 1972)
Levels in infant plasma have been measured (Erkkola 1972), and found to be more than 5 times lower than the corresponding maternal levels. (Wesson 1985)
Some authors have not observed problems in infants whose mothers took it. (Kelly2012, Erkkola 1972)
Others have reported sedation and poor suctioning in the infant (Wesson 1985, Patrick 1972), especially with repeated or high doses and during the neonatal period (Davanzo 2013). There is an increased risk of weight loss and jaundice in newborns whose mothers are given doses of diazepam greater than 0.1 mg/kg. (Gilders 2021)
Vaginal administration has a lower bioavailability than oral, reaching low plasma levels, although with a longer elimination time. (Larish 2019)
The long elimination half-life of its active metabolite, desmethyldiazepam (Jochemsen 1984), makes it inadvisable during breastfeeding.
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). Diazepam at low and isolated doses and monitoring the infant does not contraindicate breastfeeding. (Uguz 2021). It is advisable to monitor drowsiness and adequate feeding of the infant.
Choose short-acting benzodiazepines and use the lowest effective dose (Rowe 2013, WHO 2002), especially during the neonatal period and in prematurity, as they can accumulate in the infant during chronic use. (Davanzo 2013, Sachs 2013, Amir 2011)
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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