High dose Seroquel in breast feeding mother

[SGrubnich]

I currently have a mother in our NICU who is on 600mg/day of Seroquel for bipolar issues. All studies that I have looked at have been with doses ranging from 25-400mg. According to Dr. Hale's book, minimal excreation is noted via milk supply with no side effects on infant. Due to possiblility of sedation for mother, I was concerned with the risk (if any) to the infant with a higher dose. Our pharmacist was discussing half lifes and pumping/dumping some of the milk supply. If you would please get back to me with any additional information about this higher dose, I would appreciate it.
Thank you,
Sarah

[cpride]

Dear Sarah,

Quetiapine (Seroquel) has a low relative infant dose of 0.07 % to 0.1 % of mother's dose. In the studies available, no adverse effects were noted in the infants. It is suggested to monitor the infant for muscle twitching (tardive dyskinesia), facial grimicing, and sedation. The authors of one study suggest to monitor infant serum levels. Since this mother is on a high dose of quetiapine, plasma levels probably should be monitored on this infant. We would suggest that the mother pump and discard 3 hours from her dose. At 6 hours from her dose, she may pump and save her milk. This allows the first half-life to pass. Let me know if you have further questions.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center