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Lamictal (Lamotrigine) and toddler nursing

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  • Lamictal (Lamotrigine) and toddler nursing

    Three months ago, I accidentally posted a question in the healthcare providers section of the forum (oops). I am here to provide a synopsis of that question and also an update.

    I was wondering about taking Lamictal for Bipolar II while nursing my 13 month-old. My son's MD was disinclined to go along with it because (from what I understand from reading M&MM) as much as 30% of the drug passes through the breastmilk and into the baby's blood plasma. There is also a minute (3% or so) of one of us developing a deadly skin-eating rash (sounds pleasant, huh?).

    I spoke with my son's MD about why I needed it, my son's infrequent daily nursing (no more than 4 times a day), combined with the fact that he is primarily receiving nutrition from solids, plus the fact that my ob/gyn was comfortable enough with a different L3 rx that she prescribed it when my son was only a few months old. Once she understood the logic behind it, she was okay with me taking it while continuing to nurse my son. Of course we monitor him for any unusual changes, but so far so good.

  • #2
    Dear mynameismandab,

    Lamotrigine (Lamictal) is compatible with breastfeeding with close monitoring of the infant. Since your child is over one year old and breastfeeding infrequently, the child's lamotrigine level would likely be low. You can talk with your child's pediatrician about monitoring his plasma levels which is recommended to ensure safety. This can be done by a simple lab test. The normal adult dose of Lamictal is 150 to 250 mg twice daily. The amount of Lamictal that passes through breast milk is estimated to be between 9.2 to 18.3 % of your dose. The time that the Lamictal would be at the highest concentration in your milk is 1 to 4 hours after taking your dose, so avoid breastfeeding at that time if possible. Some of the side effects to observe your child for are sedation, vomiting, and tremor. Let me know if you have further questions.

    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center
    Last edited by cpride; 05-31-2011, 02:55 PM.

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