Diazepam is a substance with a high clearance time, which adds to the production of active metabolites and desmethyldiazepam also slowly eliminated and oxazepam with a more quick removal. Due to the risk of accumulation and toxic effect on the baby, it is preferable to use another substance, particularly in the case of young infants.
After administration of a single dose to the mother, it is not needed to stop breastfeeding, even if it is small infants, although is preferable to wait a period of not less than eight hours after taking diazepam . In some cases there have been levels of 100 mcg / L of diazepam in breast milk after the mother received 15 mg of the drug over the 24 hours earlier.
Although it is estimated that the highest dose of diazepam might not exceed 3% of the maternal dose weight adjusted, in some cases the sum of both concentrations diazepam and desmethyldiazepam in the blood can exceed 400 mcg/L. There have been some cases of poor weight increase, lethargy and sedation in neonates whose mothers received diazepam, especially when have been not respected the lapse of eight hours after drug intake by the mother.
Theoretically, desmethyldiazepam, a diazepam conjugate derivative, can interfere with the conjugation of bilirubin. Has not been observed an increase or a more serious case of hyperbilirubinemia in neonates whose mothers received the drug.
Warning of the manufacturer:
Because benzodiazepines are excreted in breast milk, its use is contraindicated in nursing mothers.