Ativan during night

[kelo]

Hello - I have a 7 week old infant who is exclusively breast fed. I nurse her before bed (10pm) and then again around 3 a.m. But after that 3am feeding I cannot fall back asleep. Is it ok to take .5 milligrams of Ativan after I nurse her so I am able to fall back asleep? It's the only thing that has helped me sleep in the past. She wakes up again 3 hours later. Is it safe for her to nurse at that time (6am) or is the drug still at its peak? Would you recommend giving her a bottle at that time instead? If that is the case, do I need to pump and discard that milk or simply wait until the next feeding for it to be out of my system?
Thank you!

[admin-james]

Hi, thanks for your post.

The studies that we have on Ativan (lorazepam) indicate that the infant only gets about 2-3% of the amount you take. We don't expect that to have any real effect on the baby, even if you do feed during the drug peak (1-3 hours post-dose). If you try breastfeeding at that time and have reason to think the baby is being sedated by the drug, the next step is next time to wait about 6 hours after your dose before you feed. It is not necessary or helpful to discard your milk at that time. This delay reduces the baby's exposure by about 25%. Again, the best information available suggests there will be no problem with breastfeeding whenever the child is hungry.

For anyone reading this, please post again or call us at the InfantRisk Center, (806)352-2519, if this has not completely answered your question. I would also appreciate you filling out a 2 minute survey about your time on the forum:

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-James Abbey, MD

[kelo]

Thanks for the prompt response. To be clear- if I find she's too sedated after 6am feeding, I should wait 6 hrs to feed her instead (9am) correct? At 6am should I pump to keep up milk supply - and if so, should I keep the milk or discard it? Sorry I was a bit confused.

[admin-james]

Yes, the day after you decide your child is overly sedated, you should wait 6 hours after your dose before feeding. You probably won't need to pump at 6am just to maintain supply; it usually takes longer than that to have problems. If you do pump at 6am, you should dilute that milk with hydrolyzed formula (1 part milk, 1 part formula) before giving it to the baby. I really don't think any of this will turn out to be necessary, but you never know for sure until you try. Being thorough is a good instinct.