If you have any questions about this information, you can contact the Drugs in Breastmilk team through their Facebook page or on druginformation@breastfeedingnetwork.org.uk.

You can breastfeed after sedation with midazolam as soon as you are awake and alert. However, you may feel drowsy, and your judgement may be impaired for up to 24 hours afterwards, so you will need to have another adult with you who can look after you and help you care for your child.

Colonoscopy is carried out under light sedation in order to examine the inside of the colon. A small flexible tube is passed in through the anus and into the intestine. It may be used to diagnose or exclude conditions such as inflammatory bowel disease or diverticulitis. The examination takes under half an hour and in most cases the patient is not asleep but drowsy and relaxed. For further information see the Patient.info page on colonoscopy.

The colonoscopy procedure is uncomfortable but not painful and is over in a short period. In many instances the preparation period is worse as the urgency to pass motions can be extreme. If you need to have this procedure it may be important that someone is with you to look after your baby during the bowel preparation period, as well as on the day following. You may be drowsy afterwards from lack of food in addition to the colonoscopy and sedation.

In order that the medical staff can examine the gut thoroughly, bowel cleansing is necessary to clear out all faeces in advance of the procedure. This requires a low residue diet for one or two days and the use of a strong laxative the day before the procedure to produce liquid motions as the gut is cleared.

The laxative normally used is a stimulant laxative such as sodium picosulphate (Picolax^®) which is not known to be absorbed into breastmilk or the osmotic laxative macrogol 3350. Macrogol is an inert substance that passes through the gut without being absorbed into the body. It works because it causes water to be retained in the bowel instead of being absorbed into the body. Enemas such as Fleet^® may also be used without affecting the breastfed baby. See our factsheet on constipation for more information on laxatives.

Care should be taken to ensure that you remain adequately hydrated throughout the preparation period and on the day of the procedure by drinking plenty of water as permitted by the pre-operative instructions.

Short acting hypnotics such as midazolam, fentanyl and pethidine are used during the procedure itself to sedate you and are not contra- indicated during breastfeeding unless your baby is at risk of respiratory depression.

Midazolam: The small amounts of midazolam excreted into breastmilk would not be expected to cause adverse effects in most breastfed infants. New guidelines from the Association of Anaesthetists (2026) state that no delay is necessary in any age group.

See also ASGE Guidelines for endoscopy in pregnant and lactating women (2012).

Only a low level of the drug will pass through to your child in your breastmilk, so you can breastfeed after sedation with midazolam as soon as you feel well enough. No concerns have been reported about breastfed babies experiencing side effects after their mother has been sedated with midazolam, but as a precaution it is sensible to monitor your child for drowsiness, slowed breathing rate and poor feeding, especially if they are under 6 weeks old. If you are concerned about your child, you can contact 111.

You may feel drowsy and have impaired judgement for up to 24 hours after sedation with midazolam. This may affect how easy it is for you to look after your child. Your dentist will ask you to make sure you have another adult with you for 24 hours after sedation. Ask someone who can also help you care for your baby or child. In particular, you may need help caring for your child at night, as you may be less able to respond to them. Your helper could bring your child to you when they need to be fed and remain with you whilst you are feeding them. You can speak to your sedationist about breastfeeding, and they will discuss the support you may need whilst recovering from sedation.  You can also read more about the after-effects of sedation in the leaflet Sedation Explained, from the Royal College of Anaesthetists.

Medicines that make you drowsy can make bed-sharing less safe. Baby Sleep Info Source (BASIS) have more information on sleep and safety. They recommend that you do not share your bed with your baby after you have taken medication that makes you sleepy. If you would usually bedshare, ask the adult supporting you after sedation to help you care for your child at night so that you do not need to share your bed until the effects of the sedation have completely worn off.

You can discuss the timing of your sedation with your sedationist. Having your procedure first thing in the morning may make it easier for you to breastfeed (with support from your accompanying adult) that night, as there will have been more time for the sedation to wear off.

For further information on sedation with midazolam, see our factsheet on dental sedation.

Fentanyl: No waiting period or discarding of milk is required before resuming breastfeeding after fentanyl is used for short procedures (e.g., for endoscopy) [Lactmed]

Pethidine: A single dose for anaesthesia or conscious sedation usually does not cause problems in older breastfed infants. [Lactmed]

Drugs used in this procedure are not licensed for use during breastfeeding and are therefore not recommended for use by the manufacturers. This does not imply that they are unsafe. See our factsheet on patient information leaflets for further explanation.

Bibliography

• British National Formulary
• Hale T. W Medications in Mothers Milk 2016 (17th Ed) Hale publishing
• Jones W Breastfeeding and Medication 2013 Routledge
• Drugs and Lactation Database (LactMed^®): www.ncbi.nlm.nih.gov/books/NBK501922/
• Mitchell, J., Jones, W., Morris, S., Cohen, M., Breckenridge, F., Baruah-Young, J., Fletcher, G., Edwards, S., White, M., & Wiles, M. D. (2026). Guidelines for anaesthesia and sedation for patients who are breastfeeding: Guidelines from the Association of Anaesthetists. Anaesthesia, 10.1111/anae.70128. Advance online publication. https://doi.org/10.1111/anae.70128 
• ASGE Standard of Practice Committee, Shergill AK, Ben-Menachem T, et al. Guidelines for endoscopy in pregnant and lactating women [published correction appears in Gastrointest Endosc. 2013 May;77(5):833]. Gastrointest Endosc. 2012;76(1):18-24. doi:10.1016/j.gie.2012.02.029

©The Breastfeeding Network. Last full review August 2020. Last updated February 2026.