I would like to know where on earth the 20 mg upper limit came from, eh?
If the baby can get methadone during pregnancy, why can't he get some
during lactation (he will get a *lot* less and at a less sensitive
time).  Remember the risks of formula feeding.  Remember that
breastfeeding and being a parent can change people.  I just heard of a
new mother, 17 years old, heavy smoker throughout the pregnancy, told
she couldn't breastfeed because she smoked and baby premature.  She did
it anyhow, still breastfeeding her 10 month old.  Stopped smoking,
stopped her husband smoking.  A triumph.  Why?  Because someone said to
her, "it's better you breastfeed and smoke than formula feed and smoke".
The benefits to three people are unmeasurable.

The aprazolam does have a long half life, but the baby again has been
getting it through pregnancy.  Thus, he will have enzymes induced in his
liver to help detoxify it.  How about finding a benzodiazepine with a
shorter half life?  How about not worrying and seeing what happens?

Jack Newman, MD, FRCPC