Buspirone, a medication prescribed for anxiety, raises questions about its compatibility with lactation. This article addresses how buspirone might affect a breastfed infant.
Buspirone Explained
Buspirone treats anxiety disorders, especially generalized anxiety disorder (GAD). It is preferred over some other anxiety medications due to a lower risk of dependence. Its effects involve serotonin receptors, though the exact mechanism is complex. Full benefits typically appear within two to four weeks.
Presence in Breast Milk
Buspirone transfers into breast milk at very low levels. A 2024 study found buspirone concentrations in breast milk were below the detection limit (1.5 ng/mL) across maternal dosages up to 30 mg twice daily. While the parent drug was minimally detected, low levels of its active metabolite, 1-pyrimidinylpiperazine (1-PP), were observed.
The Relative Infant Dose (RID), which estimates infant exposure through milk, ranged from 0.21% to 2.17%. This is well below the 10% threshold considered safe, indicating clinically insignificant transfer. Other sources also support low levels in milk with maternal doses up to 45 mg daily.
Monitoring the Infant
While buspirone transfer into breast milk is low, parents should monitor their infant for any behavioral or health changes. In studies, no adverse effects were reported in breastfed infants exposed to buspirone. Monitoring for signs like unusual drowsiness, feeding changes, increased irritability, or sleep disturbances is recommended.
One isolated case described seizure-like activity in a three-week-old infant whose mother was taking buspirone along with other medications, though buspirone was considered an unlikely cause. Another report detailed an infant with decreased growth, tremors, low muscle tone, low blood sugar, and feeding difficulties, but this infant was exposed to multiple factors, including other medications and cigarette smoke, making it unclear if buspirone was the cause. These instances highlight the importance of careful observation.
Making Informed Decisions
Deciding on buspirone while breastfeeding requires discussion with healthcare professionals. This conversation should include the prescribing doctor, the infant’s pediatrician, and potentially a lactation consultant. Together, they can help weigh the benefits of the medication for the parent’s mental well-being against the minimal potential risks to the breastfed infant.
Individual factors like infant age, health, and buspirone dosage are important. Extra caution may be needed for premature or very young infants (under six weeks) due to immature liver function. Healthcare providers may also suggest starting with the lowest effective dose and timing medication intake immediately after a feeding to maximize the time for the drug to clear before the next feeding.