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Clonazepam is 3 times a day and bupropion twice a day. I was also prescribed lithium but I've heard so many negative things about breastfeeding while on lithium. I've taken these meds for years but stopped taking them throughout my pregnancy. My baby is 6 months now and I would really like to get back on my meds. My anxiety and depression have been bad lately. And ive been getting panic attacks. If I maybe start with taking them only once a day early morning would that affect the baby ? Please help!
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Susana Parker,
Clonazepam is rated an L3-limited data-probably compatible. The amount that transfers into breast milk is 2.8% of your dose. Clonazepam peaks in 1-4 hours, and has a long half-life of 18-20 hours. We recommend if you are going to take this medication while breastfeeding to keep the dose low (0.5mg is considered a low dose) and to avoid the peak times. I think if you start on 0.5mg once a day it will probably be ok as long as your infant is not symptomatic. Monitor your infant for sedation, slowed breathing rate, not waking to feed/poor feeding and weight gain.
Wellbutrin is rated an L3-limited data-probably compatible. The amount that transfers into breast milk is 0.11-1.99% of your dose. We think this one is probably ok as long as your infant is not symptomatic. Monitor for sedation or irritability, seizures, not waking to feed/poor feeding and weight gain.
Lithium is rated an L-4-significant data-possibly hazardous. The amount that transfers is 0.87-30% of your dose. "Lithium readily transfers to the infant via milk. Infant plasma levels can be significant. If closely followed, most infants could continue to breastfeed, but close followup by a physician is mandatory. If the infant continues to breastfeed, it is strongly suggested that the infant be closely monitored with serum lithium levels, and BUN/creatinine after 6 weeks or so. Levels drawn too early (7 days) may only reflect in utero exposure. A number of studies of lithium suggest that lithium administration is not an absolute contraindication to breastfeeding, if the physician monitors the infant closely. Use with great caution." (Medications and Mothers' Milk database, Dr Thomas Hale PhD) We believe there are better alternatives, but if you decide to take it monitor for neurobehavioral development, drowsiness, irritability, dry mouth or excessive salivation, thyroid function, vomiting, constipation, hydration, renal function, urination, tremor.
Sandra Lovato R.N.
InfantRisk Center
806-352-2519
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