Pregnancy: Because midazolam crosses through the placenta and passes into breast milk, it must not be used during the first three months of pregnancy. Midazolam should not be used during the last six months unless this is considered essential by the treating physician. As with all benzodiazepines, high doses of midazolam must not be administered during the last three months of pregnancy.
Particular caution is required if benzodiazepines are administered during delivery, because high single doses may produce cardiac arrhythmia and hypotonia in the foetus, and cause hypothermia, hypotonia, respiratory depression and poor sucking (floppy infant syndrome) in the neonate.
The risk of abnormalities with ingestion of therapeutic doses of benzodiazeplnes at an early stage in pregnancy appears to be low, although a number of epidemiological studies have revealed evidence of an increased risk of cleft palate. There have been a few case reports of deformities after overdose and Intoxication.
Lactation: Midazolam passes into breast-milk. Therefore, if midazolam is administered parenterally during lactation, breast-feeding should be interrupted for 1-2 days as a precausive measure.