This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Z drugs (zolpidem and zopiclone) in breastfeeding

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • cause of the insomnia should be identified before a medicine is prescribed and, where possible, underlying factors should be treated
  • good sleep hygiene should be established to raise awareness of behavioural, environmental and temporal factors that may be detrimental or beneficial to sleep

Any decision to treat a sleep disorder with medication needs to be carefully considered, taking into account the usual sleep deprivation associated with a newborn infant

  • use of medicines to treat insomnia during breastfeeding should be approached with caution
    • where possible use short-term, intermittent dosing, and the lowest effective dose to reduce infant exposure
  • the ‘z- drugs’ (zolpidem and zopiclone) are preferred for the short-term management of insomnia during breastfeeding, as they have shorter half-lives than the benzodiazepines and appear to pass into breast milk in small amounts (1):
    • zolpidem
      • estimated infant dose < 0.02% the maternal dose (2)
      • stated by the American Academy of Pediatrics (AAP) as safe for lactation (2)
    • zopiclone
      • estimated infant dose about 3.2% of maternal dose (2)
      • unlikely toxicity but effects of chronic exposure unknown (2)
    • melatonin can also be used in breastfeeding with caution
  • monitor the infant closely for side effects, such as drowsiness.
  • may present as not waking up to feed/falling asleep whilst feeding, which may affect weight gain
  • note that NICE advises to avoid sharing a bed with the infant when sedating medication has been used, due to the increased risk of sudden unexpected death in infancy


Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.