Abstract
The use of psychoactive medication in treatment of anxiety and insomnia during pregnancy and lactation raises a number of clinical challenges. Earlier studies suggested that treatment with benzodiazepines is associated with congenital malformations, especially oral clefts.
However, more recent findings are equivocal. Benzodiazepines in neonates and breast-fed infants may cause sedation and withdrawal symptoms.
The 'floppy infant syndrome' is characterized by facial features and CNS dysfunction and can occur with higher doses of long-acting benzodiazepines. Benzodiazepines are excreted in breast milk, their use during lactation should be avoided.
The can produce lethargy and weight loss. If pharmacotherapy of anxiety and insomnia during pregnancy is necessary, lorazepam and alprazolam should be preferred over long-acting benzodiazepines and clonazepam.
In lactation, low single doses are probably of low risk, especially if the infant is monitored for drowsiness.