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Expert Q&A

	By Melissa Clark Vickers International Board Certified Lactation Consultant Moms & Babies Huntingdon, Tenn.

I'd like to breastfeed my baby, but I have to take Valium. With the help of my doctor, I reduced the quantity to 1 mg at night. On the other hand, I've got mastitis fibroquist, and lactation would be a good way to reduce the incidence of cancer. What it is your opinion? My physician tells me not to worry because the amount of valium is minimal. Can I extract the milk and feed my baby with artificial milk to keep the benefits to my health (in terms of reducing my cancer risk)?

There are many factors which affect whether it is safe to take a drug if you are nursing a baby, including the dosage, the baby's age, how the adult processes the drug, and how the baby processes the drug. Obviously a smaller dose of a drug is less likely to be of concern than a larger dose. A newborn, whose system is not mature enough to deal with processing drugs is at greater risk than an older baby who may be getting nourishment from solid foods.

Some drugs won't pass through to the milk in large quantities, while some will pass through such that the amount in the milk is the same or greater than the amount circulatingin a mother's blood.

Valium is listed by the American Academy of Pediatrics as a "drug whose effect is unknown but may be of concern." Your doctor is certainly in the best positionto help you make this decision.

Breastfeeding does reduce a mother's risk for cancer, and generally the longer you breastfeed, the greater that protection. Pumping only, without breastfeeding directly at the breast, is difficult to maintain for any length of time. I honestly don't know whether the protective effects of breastfeeding would hold up in this kind of situation.

You might discuss withyour doctor the possibility of your taking another drug which might be less of an unknown than Valium. In any case, you are to be commended for thinking this through ahead of time. Ultimately, you can make the decisions that seem best for you. The more information you get, the better that decision will be.

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