Breastfeeding Toddler + Abilify and Lamictal

[CallMeStephanie]

I was diagnosed bipolar when I was about 16. I was on abilify and lamictal in 2012 but decided to wean off to get pregnant. I felt able to go through my pregnancy without medication but after giving birth I was hit with PPD badly. I didn't have insurance though. I still don't but I found a income based clinic that charges on a sliding scale. Went today and the Dr said he was going to prescribe 25mg Abilify (I think that was what it was) and 25mg Lamictal working up to 100mg, then weaning off abilify.

I'm currently breastfeeding my 15 month old toddler. She's about 20lbs. She nurses no more than 4 times a day, about 5-10 minutes each but usually it's once in the morning, once in the afternoon, and rarely at night.

Neither she nor I are really ready to stop breastfeeding but if either or both meds wouldn't be safe for her, I would stop.

Thank you for any advice!

[admin-james]

Hi, thanks for your post.

There are not many direct studies on how Abilify behaves in breastmilk. What we do have suggests that only around 1-5% of the mother's dose makes it to a full-time breastfeeding baby. Toddlers get much less breastmilk relative to their body weight than infants, so this number will be much smaller in your case. It is highly unlikely that this small amount will be noticeable or dangerous to your child. We give Abilify an L3 rating (out of 5) ("Probably compatible"), mostly because of the lack of information.

Lamictal (lamotrigine) goes into breastmilk at a rate of around 10-20% of the mother's dose and again, that number will be considerably smaller for toddlers. The amount that your child might get through the milk is still less than what is prescribed directly to children to treat seizures. Watch out for any new rashes, sleepiness, or upset stomach. We give Lamictal an L2 rating (out of 5) ("Safer").

Please call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519

-James Abbey, MD

[CallMeStephanie]

Hi, thanks for your post.

There are not many direct studies on how Abilify behaves in breastmilk. What we do have suggests that only around 1-5% of the mother's dose makes it to a full-time breastfeeding baby. Toddlers get much less breastmilk relative to their body weight than infants, so this number will be much smaller in your case. It is highly unlikely that this small amount will be noticeable or dangerous to your child. We give Abilify an L3 rating (out of 5) ("Probably compatible"), mostly because of the lack of information.

Lamictal (lamotrigine) goes into breastmilk at a rate of around 10-20% of the mother's dose and again, that number will be considerably smaller for toddlers. The amount that your child might get through the milk is still less than what is prescribed directly to children to treat seizures. Watch out for any new rashes, sleepiness, or upset stomach. We give Lamictal an L2 rating (out of 5) ("Safer").

Please call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519

-James Abbey, MD

Thank you. That's about what I came up with my research as well. Makes me feel very confident in continuing to breast feed.