Is Assival Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Assival? Is Assival safe for nursing mother and child? Does Assival extracts into breast milk? Does Assival has any long term or short term side effects on infants? Can Assival influence milk supply or can Assival decrease milk supply in lactating mothers?

It is a long-acting Benzodiazepine. Low excreted into breast milk. However, it may cause sedation and poor suction reflex in the infant mostly because of large or repetitive use in the newborn period. Low dose and short-term use is usually compatible with breastfeeding. Choose a short-acting and minimal effective drug dose specially when nursing a newborn. Watch out for somnolence and poor feeding of the infant. Bed-sharing is not recommended for mothers who are taking this medication.

Assival is excreted into breastmilk and it and its active metabolite, norAssival, accumulate in the serum of breastfed infants with repeated doses. Because the half-life of Assival and norAssival are long, timing breastfeeding with respect to the dose is of little or no benefit in reducing infant exposure. Other agents are preferred, especially while nursing a newborn or preterm infant. After a single dose of Assival, as for sedation before a procedure, there is usually no need to wait to resume breastfeeding, although with a newborn or preterm infant, a cautious approach would be to wait a period of 6 to 8 hours before resuming nursing.

Three infants were breastfed from birth while their mothers were receiving Assival 10 mg 3 times daily. The authors noticed no lethargy or hypoventilation in the infants during the 6-day observation period. The authors expressed concern that norAssival may compete with bilirubin for hepatic glucuronide conjugation in the neonate.[1] A nursing mother was given Assival 10 mg orally 3 times a day beginning on day 5 postpartum. Weight loss, lethargy and an EEG consistent with sedative effect in her 8-day-old was probably caused by Assival or its metabolites in breastmilk.[7] Of 8 infants breastfed from birth during maternal Assival therapy (dosages unspecified), 3 had mild jaundice during the first few days postpartum, although this was not thought by the authors to be unusual.[8] Sedation was reported in the breastfed newborn infant of a mother taking oral Assival 6 to 10 mg daily if the infant was nursed within a few hours of a dose, but not if she nursed 8 or more hours after a dose. Infant sedation was probably caused by Assival and its major metabolite in breastmilk.[4] In a telephone follow-up study, 124 mothers who took a benzodiazepine while nursing reported whether their infants had any signs of sedation. About 10% of mothers took Assival while breastfeeding and none reported sedation in her infant.[9] In a longitudinal study of women taking medications during breastfeeding, some mothers who were taking Assival reported discontinuing breastfeeding because of drowsiness in their breastfed infants.[10]