Is Evacalm Safe in Breastfeeding

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

Evacalm is excreted into breastmilk and it and its active metabolite, norEvacalm, accumulate in the serum of breastfed infants with repeated doses. Because the half-life of Evacalm and norEvacalm 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 Evacalm, 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 Evacalm 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 norEvacalm may compete with bilirubin for hepatic glucuronide conjugation in the neonate.[1] A nursing mother was given Evacalm 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 Evacalm or its metabolites in breastmilk.[7] Of 8 infants breastfed from birth during maternal Evacalm 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 Evacalm 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 Evacalm 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 Evacalm 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 Evacalm reported discontinuing breastfeeding because of drowsiness in their breastfed infants.[10]