0.25 alprazolam and breastfeeding

[Reign67]

Hi,

I need some advice, I am currently breastfeeding my 12 week old. I have started taking my alprazolam again 0.25 dose at night ( I have tried other safe meds like ativan and it does not work) for my extreme insomnia and anxiety at night. I take my dose around 10 pm after I feed my baby. I have been supplementing with formula during the night and I resume feeding around 10 am in the morning. Is my baby at any risk? I do a pump and dump before I start feeding again. I am just so unsure and want to be as safe as possible. I have thought about switching to formula exclusively but its very hard to wean because I really don't have any other.

please let me know if I should stop breastfeeding. I know it stays in your milk for up to 14 hours but I figured since my dose is so low it should be okay.

thank you in advance and sorry if this does not make sense.

[Sandra]

Reign67,

We think alprazolam at low doses is probably compatible with breastfeeding as long as your infant is not symptomatic. The amount that transfers into breast milk is 8.5% of your dose. A 0.25mg dose once at night is considered a low dose. Alprazolam is most concentrated in the breast milk in 1-2 hours after a dose, and the half life is 12-15 hours. It is not necessary to pump and dump your milk. We usually advise to just try to avoid the peak times and monitor your infant for sedation, slowed breathing rate, poor feedings and poor weight gain.

Sandra Lovato R.N.
InfantRisk Center