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I was not sure where to post this since there is not a mood stabilizer category. I have a client who is bipolar. She has an 8 month old who was born full term and now weighs 17 1/2 lbs. She nurses 3 times a day and once at night. The infant also takes 3 solid meals and takes one bottle of formula in the evening. The mother has tried depakote with no success and needs to go back on her lithium. She usually takes 900 mg a day and has around a .5 lithium level. Is there a protocol she should follow being on the lithium? What are the health risks to the infant with the frequency of nursing and her lithium level? I have Medications and the Mothers Milk and have read on lithium. I was hoping to find out a little more specifics in regard to this case since it appears her levels seem to be a bit lower than average..
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Dear Rogers929,
Lithium is a potent drug and should be used cautiously. That being said, it is not contraindicated in breastfeeding as long as the patient is being monitored closely by her physician. The blood lithium level in the infant is estimated to be one-third the maternal amount. Since the mother's level is low (0.5), the baby's level will be even lower and not likely to cause any problems. However, lithium levels should be checked periodically in both mother and child. The baby should also be monitored for diarrhea, nausea, vomiting, tremor, and urinary frequency which are side effects caused by lithium. Hope this is helpful.
Sincerely,
Maria Milla, MD
InfantRisk Center
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