Jessica asked
I had a panic attack and was given 1mg of Ativan through an IV at the local ER. I am a breastfeeding mother. I gave my baby formula for the last 2 feedings. It has now been 6 hours since the ER visit. Can I breastfeed now?
Answer
Ativan (lorazepam) is excreted into the breast milk and is not recommended for breast feeding mothers according to the prescribing information.
The exact amount, and how long Ativan is detectable in the breastmilk after dosing, isn't well know but the overall concentrations are thought to be low. One study found that breastmilk concentrations of Ativan 4 hours after a 3.5 mg dose ranged from 14.8% to 25.7% of the mother's blood concentrations.
Another study found that Ativan was detectable in the breast milk 5 days after maternal dosing, but in concentrations low enough where there were no side effects noticeable in the infants breastfeeding.
Most review studies on the subject of Ativan use during breastfeeding state that the total exposure in the breast-fed infants is not very high. Nevertheless, caution is recommended as infants metabolize benzodiazepines, such as Ativan, more slowly than in adults and accumulation may potentially occur with continuous dosing, which could lead to side effects in the infant such as:
- Sedation
- Nausea
- Reduced appetite/suckling
While there is no single recommendation in regard to how long to wait after an Ativan (lorazepam) dose to breastfeed, you should wait at least 4 to 6 hours, as we know by that time breastmilk concentrations will be significantly less than maternal concentrations of the drug. However, as discussed above, there is a good chance your breastmilk will contain at least trace amounts of Ativan for several days, although the effects on infants don't appear significant.
As everyone's medical situation is different, be sure to speak with your doctor regarding your options for breastfeeding your infant after your dose of Ativan.
