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Low dose Klonopin & breastfeeding?

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  • Low dose Klonopin & breastfeeding?

    Hi Dr. Hale/other professionals:

    I am nursing my 11+ month old twins 3x/day, each time for about 5 minutes. They also eat a lot of all kinds of food. They are both healthy, active, meeting milestones; my daughter is small for her age but has been tracking her growth curve since birth.

    I've been taking Zoloft daily since the 3rd trimester for depression and significant anxiety, increasing the dose bit by bit under a doctor's care.

    My anxiety has been ramping up in the last few months to the point that it interferes regularly with my daily life (I stay home with my twins and 3 year old), including panic attacks and an acute episode that lasted 5 days when my anxiety was literally through the roof and I was barely functional.

    My doctor just increased my Zoloft to 200mg/day, and added Klonopin 0.5mg/day. I'm comfortable with the small risk of Zoloft, but am concerned about the Klonopin. However - I took a first dose today to see if I would be too sedated to care for my kids, etc., and it was like night and day. 95% of my brain spinning, anxiety, worrying, obsessive thinking, etc., was just ... gone. I was absolutely a better parent today than I've been in months. So I'm trying to weigh the cost/benefit - should I take it daily? As needed? Wait until I've weaned the twins? I was also wondering if I should expect to develop a tolerance at this dose; a former therapist said that at this kind of low dose tolerance is uncommon and recommended I take this medication when I was done with pregnancy/nursing, indefinitely.

    If I start weaning the twins today, it'll take at least a month or so.

    I would really appreciate any guidance, thank you so much!
    Last edited by tadpole; 10-30-2013, 11:16 PM.

  • #2

    At this age, and considering the the volume of milk you are delivering to these twins (which is lower), I would not at all be concerned about this dose of Klonopin. Only 2.8% of your dose would actually enter milk. This is simply not enough to have a clinical effect on the infant.

    Just observe for sedation. If you don't see it, no problem. Remember, a healthy mom makes a better baby.

    Tom Hale Ph.D.