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Midazolam as a sedative for procedures in breastfeeding mothers

The reason I write these factsheets is in response to the questions which are posed to me on social media. I have included the use of midazolam in fact sheets on colonoscopy, endoscopy and dental sedation on information on the Breastfeeding Network but still mothers are told that they need to delay procedures, are only allowed gas and air during the procedure or must stop breastfeeding for 24 hours. The latter is recommended by the manufacturers but since the half life is 3 hours it is all gone from the mother’s body and therefore her milk within 15 hours. However, looking at the pharmacokinetics of midazolam use as a single dose sedative is not a contra indication to normal breastfeeding as confirmed

Guideline on anaesthesia and sedation in breastfeeding: https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.15179

“Midazolam: extensive first-pass metabolism results in low systemic bioavailability after oral doses, so blood levels in the infant after breastfeeding can be expected to be low [20]. Breastfeeding can be resumed after a single dose of midazolam as soon as the woman has recovered from the procedure.”

Midazolam and colonoscopy

Midazolam and dental sedation

Midazolam and endoscopy factsheet

This factsheet contains information taken from my book Breastfeeding and Medication 2018. I hope it helps breastfeeding mums and professionals

Midazolam factsheet