Of course, there is more information on tricyclic antidepressants and breastfeeding since my article was published in 1990, but none of the information currently available or what I have seen in my practice has changed my recommendation that, with proper monitoring, that tricyclic antidepressants are compatible with breastfeeding, especially for agents such as nortriptyline (Pamelor) at doses up to 125mg/day or desipramine (Norpramin) at doses up to 30mg/day. Regarding diazepam, diazepam and its metabolite enter milk and may accumulate in infants, even at low doses. Its use is not recommended; if used, infant must be closely monitored (lethargy, sucking problems, withdrawal symptoms). Whether to use it or not would be based on the indication for the mother. If for a mother in status, why not use it and continue breastfeeding. If used for other reasons, other benzodiazepines could be substituted. In general, a single dose or repeated low doses of benzodiazepines are unlikely to produce adverse effects on health infants; prolonged, high dose treatment should be avoided. Hope this is of some help to the nursing students who asked for opinions Frank J. Nice, DPA, CPHP