To:    Jill Meltzer
Subject: Breastfeeding and Xanax

Xanax(Alprazolam)  is a prototypical benzodiazepine,  similar to
Valium(diazepam).  It differs from other BZs by the fact that is has a
rather shorter half-life  12-15 hrs.   It peaks at 1-2 hours.  We do not
know the concentrations that enter milk,  but I would assume them to be
similar to that of Valium.  The milk:plasma ratio of Valium varies but is
generally less than 1.0.   Although concentrations of Valium high enough to
produce sedation have been reported,  remember that valium has a long
half-life(active)  metabolite that could account for some of this.   But in
reality,  we do not know how much Xanax  will accumulate in an infant, at
this time.

If the dose is kept minimal (0.25 mg bid - tid)  it is not very likely that
signficant concentrations will accumulate in this neonate,  but the mom
should be observant for changes in mental acuity(sedation, drowsiness),  and
hypotonia(flaccidity, weakness).     If she opts to continue the medication
and breastfeed,   suggest the mom wait several hours after administering the
med before feeding the infant.

 I am sorry there are no specific recommendations for this product.

Tom Hale