Lorazepam and oxazepam are the preferred benzodiazepines during breast feeding, if clinically appropriate. Recommendations apply to full term, healthy infants.

General considerations

It is important to complete an individual risk assessment for your patient and to apply the principles of prescribing in breastfeeding when looking at the available information and making treatment decisions.

This article includes the most commonly used benzodiazepines. Other benzodiazepines are available, and may need to be used for more specialist situations. Contact our specialist service for further advice.


Using benzodiazepines in breastfeeding should be approached with caution, and the lowest effective doses should be used.

Shorter acting agents, such as lorazepam and oxazepam, are preferred, where this is clinically appropriate.

However, choice should primarily be directed at adequately treating the condition first, with safety in breastfeeding a secondary consideration.

The National Institute for Healthcare Excellence (NICE) advises avoiding sharing a bed with the infant when sedating medication has been used, due to the increased risk of sudden unexpected death in infancy.

Clinical considerations

Anxiety and sleeping disorders

Benzodiazepines should be used with caution for anxiety and sleeping disorders in breastfeeding. They generally have long half-lives and could potentially accumulate in the breastfed infant following prolonged administration, leading to possible sedation and increased risk of apnoea.

Where possible use short-term, intermittent dosing to reduce infant exposure.

The ‘z’ drugs, such as zopiclone and zolpidem are preferred for sleeping disorders as they have shorter half-lives and appear to pass into the breast milk in small amounts.

Withdrawal effects may occur in infants if a mother suddenly stops breastfeeding.


Benzodiazepines are used for premedication and for conscious sedation during surgery. Following short-term therapy (1-2 doses) for these indications, breastfeeding can be resumed as soon as the mother has recovered sufficiently from the procedure.


Benzodiazepines are also used for epilepsy. Choice will depend on the clinical condition and should primarily be based on suitability for the patient rather than safety during breastfeeding.

Combination therapy may pose an increased risk to the infant, especially when adverse effects such as drowsiness are additive.

Withdrawal effects may occur in infants if a mother suddenly stops breastfeeding.

Specific recommendations

Patient Information

The NHS website provides advice for patients on the use of specific medicines in breastfeeding.

Contact us

Get in touch with the UK Drugs In Lactation Advisory Service (UKDILAS), our specialist breastfeeding medicines advice service if you need support in the following situations:

  • you need further advice
  • the medicine in question is not included here
  • the infant is unwell or premature
  • multiple medicines are being taken

About our recommendations

Recommendations are based on published evidence where available. However, evidence is generally very poor and limited, and can require professional interpretation. Assessments are often based on reviewing case reports which can be conflicting and lack detail.

If there is no published clinical evidence, assessments are based on: pharmacodynamic and pharmacokinetic principles, extrapolation from similar drugs, risk assessment of normal clinical use, expert advice, and unpublished data. Simulated data is now increasingly being used due to the ethical difficulties around gathering good quality evidence in this area.


Full referencing is available on request.