When women become pregnant their doctors automatically advise a diet rich in nutrients, vitamins, and minerals to help the baby’s development as much as possible. On the other hand, some are confused about which artificial drugs or medicines they can prescribe for mothers.
Since the Food and Drug Authority (FDA) does not allow drug companies to ask lactating women to join studies, there are very few scientific studies that we can fall back on. However, there are some drugs we can already advise on, such as Xanax. Let us look at what happens when Xanax and breastfeeding mix.
What is Xanax?
Xanax is a brand name of the generic drug alprazolam, which is a benzodiazepine. That simply means that it belongs to the family of drugs that is used to treat panic and anxiety disorders. It is best to use Xanax only when prescribed by the doctor, and following the prescription exactly.
Xanax may be habit-forming, so following the prescription is important. It is also dangerous enough to cause addiction, and even severe illness or death when overdosed on. Xanax is also a sedative, which makes its users sleepy or unfocused. It also slows their reactions, making it dangerous for them drive and other related activities while on Xanax.
Xanax has been expressly forbidden for pregnant mothers. The drug is strong enough to cause possible birth defects, and the unborn baby may develop an addiction to it. The doctor must be told at once if you suspect you are pregnant.
Do Xanax and Breastfeeding Mix?
In a study by Oo, Kuhn, and Desai, in Br J Clin Pharmacol, looking at the maternal levels of alprazolam in mothers’ breast milk after a daily dose of 0.5 mg of the drug, they found that the half-life of alprazolam in the milk is long: 14.5 hours, more than half a day. After taking the drug, mothers need to wait at least this time period before breastfeeding their babies.
Later evidence of the effects of Xanax on breastfeeding babies was gathered from current cases, not through studies and tests. In one case found in a letter by scientists Anderson and McGuire, an infant 1 week old showed signs of withdrawal from the drug (irritability, restlessness, anxiety) after he stopped breastfeeding. His mother had been taking alprazolam after delivery. The case suggests the drug was in her milk in a strong enough dosage to cause some dependency.
Another case is of a baby 9 months old, whose mother was taken off alprazolam. For 2 weeks after the mother was completely off the drug, the baby showed withdrawal symptoms. He would cry randomly, was irritable, and slept fitfully.
Babies have also been known to fall heavily asleep during or after breastfeeding, reacting to the sedating side effects of the drug. When they wake up, they are unusually upset, anxious, and irritable. These stress factors sometimes lead to weight loss in the baby. In other words, Xanax and breastfeeding do not mix.
What If I Need to Use Xanax?
If you need to use it regularly or over a set period of time, you might need to consider weaning your baby or consulting your doctor or IBCLC (International Board Certified Lactation Consultant) to see if you can get another kind.
However, if you have been prescribed the drug for single use only, take it after pumping, freezing, and storing enough milk for a 14+ hour wait. You can also use bottle-fed formula milk for those times. Simply prepare in advance for your baby’s feeding.
If you have not yet weaned your baby (taken baby off breast milk), and are not in the process of weaning, you are probably planning to still breastfeed your baby after the Xanax dose. In that case, use a breast pump during regular feeding times to signal the breasts to keep producing milk. Dump the milk drawn over those times, until the half-life is done.
Alternatives to Xanax for Breastfeeding Mothers
A study of breastfeeding mothers with 124 infants total among them was undertaken by scientists Kelly, Poon, Madadi, and Koren in a study in J Pediatr. In that study, all the breastfeeding mothers were currently taking benzodiazepines. 52% of the mothers were taking lorazepam, 18% were taking clonazepman, and 15% were taking midazolam.
Of the babies currently breastfeeding, only 2 became sedated after nursing. One of the 2 nursing mothers was on alprazolam (Xanax), while the other was on multiple anti-depressant drugs. The other mothers did not report any kind of sedation occurring in their infants after their breastfeeding times.
However, these benzodiazepines are still labelled high-potency, and they will enter the breast milk. Taking these Xanax alternatives must still be by prescription, and the precautions outlined for mothers taking benzodiazepines in one-time use should still be followed. When it comes to baby’s safety, no risks should be taken.
Why Can You Ask A Lactation Consultant About Xanax and Breastfeeding?
Sometimes, especially in the news, lactation consultants are negatively portrayed–even called “Lactation Police.” This is a terrible perception that does not take into account what IBCLCs need to go through simply to get their titles. Lactation consultants must have spent hundreds of hours simply studying the theories of lactation and in clinical practice. The minimum that some lactation consultants must spend in clinical practice is 300 hours.
Lactation consultants are trained to have a single specialty: the health, welfare, and happiness of a mother who wants to breastfeed and her baby who is breastfeeding. They are equipped to give advice, counsel, and support to mothers. They can even advise and counsel on what mothers should and should not take while breastfeeding–and this includes drugs like Xanax.
Conclusion: Err on the Side of Safety
With all the evidence laid out, the decision is still yours, as the breastfeeding mother. If you do not feel comfortable taking Xanax while breastfeeding, then you do not have to take it. At the end of the day, after consulting and researching, if the doctor prescribed the drug then you can decide to take it. However, for your safety and your breastfed baby’s, always make a fully informed, regulated decision in questions like these.