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Mom of three, MD
Mom of three, MD, Board Certified Pediatrician
Category: Pediatrics
Satisfied Customers: 167
Experience:  Private practice pediatrician; reputation for being a superb diagnostician and caring, loving doc
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I am currently taking Xanax 0.5mg after I breast feed at night,

Customer Question

I am currently taking Xanax 0.5mg after I breast feed at night, for sleep anxiety. I breast feed my 8 month old 8 hours later. Is this ok or should I be expressing and discarding and then waiting for a longer period or should I stop breast feeding and express & discard the whole time I am on this drug
Submitted: 7 years ago.
Category: Pediatrics
Expert:  Mom of three, MD replied 7 years ago.
Hello, first it is WONDERFUL that you are giving your baby the benefits of mother's milk. How long have you been on the Xanax, and what have you observed about baby's behavior afterwards?
Customer: replied 7 years ago.
I only took 0.5mg one night ago. Last night I did not take it and I did not get any sleep at all, so it seems I may need to take it every night. My Doctor was ok with me taking it at 0.25mg three times a week for sleep and I could continue b/f but 8 hours after my night dose, but only 0.5mg got me to sleep the other night. My son is a bit irritable today and is tired but does not want to sleep and is not wanting much solids but the weather is very hot today which may be why he is irritable plus I am tired and irritable which he may be picking up on
Expert:  Mom of three, MD replied 7 years ago.
Thanks for the additional information. The first thing I think everyone can agree on is that it is definitely best for baby if mom is rested and feeling well. So if you cannot sleep without medication, the goal (from my point of view) would be to find a medication that works well for you, and is safe for your baby. Like any good mom you are worrying about whether you should take it, then worrying if you do take it (will it affect baby???) and worrying that if you don't take it, you'll be up all night and miserable... there is a better solution, I'm sure! I agree with your doctor that a low dose, not taken nightly, would be ok for baby. I am less confident about the safety if you need a full 0.5 mg every night. There is no evidence either way about any long-term harm to babies exposed to Xanax through nursing, but there is clear evidence that when moms take it nightly and then stop, they notice behavior changes in babies that are suggestive of mild withdrawal. I say this not to worry you more, but to encourage you to find a doctor who will work with you to find a medication that will help you rest, without adding to your worries, and without potentially medicating your little one. I am not suggesting that you are depressed, but the SSRI's, a drug class originally marketed as antidepressants, have been shown to work better for anxiety than the benzodiazepines (of which Xanax is one). I would consult a neurologist or perhaps a psychiatrist-- they are the true experts at drugs that affect anxiety and sleep. It is VERY possible (probable, even) that they could find a drug that allows you to sleep and does not pose undue risk to baby. I wish you all the best...
Customer: replied 7 years ago.
So for the time being until I have a chance to go back to the Doctor which would be about 5 days away should I express and discard or just keep b/f as usual with the 8 hour wait afterward? as it's for a potential short period before I can look at something more suitable
Expert:  Mom of three, MD replied 7 years ago.
Great question. Some issues that will help me give the best advice... how does he do with bottles? Formula? How much food is he eating at this point?
Customer: replied 7 years ago.
He is ok with formula as has this once a day anyway and has food twice a day. He has formula sometimes if I am out and about and my husband gives him the formula if its feed time
Expert:  Mom of three, MD replied 7 years ago.
That's good news. There is no one correct answer as to what you should do. You could keep nursing, take whatever dose of Xanax you need to get rest, and get to the doctor within the week. This would be a safe option, as it is short- term, and he is getting a good amount nutrition from food (in other words, he's not drinking only breastmilk, in which case I might worry a bit about the amount of Xanax).

Another very reasonable option would be to pump and dump when you first wake up and feed him a bottle for that first morning feeding. This is less convenient (dealing with pump and bottles) but only for a few days, so it might be worth it.

I certainly do not think you need to stop breastfeeding, and you also do not need to give up on the possibility of sleep. I am very hopeful that an SSRI or other med will make this problem much simpler, but at the end of the day an exhausted mom is no good to herself or her baby, and you can and should do whatever you need to do to get rest.

One final thought- does the Xanax knock you out? If so, is your husband "on call" in case the baby needs something at night?

Best of luck- you deserve it!

Edited by Mom of three, MD on 11/21/2009 at 4:24 AM EST