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Abilify - breastfeeding and supplementing with formula?

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  • Abilify - breastfeeding and supplementing with formula?

    Hello,

    My wife is currently taking 2.5 mg/day of Abilify (aripiprazole) and 100 mg/day of Lamictal (lamotrigine). She is 32 weeks pregnant and started her current medication, which is very efficient for the treatment of her cyclothymia and BPD, a few months before her pregnancy, so the baby has been exposed from the start. After weighting the pros and cons, we decided to maintain the medication during the pregnancy, which is going fine so far. We read Dr Hale's book pages about both these molecules and are aware of the state of science about them when it comes to breastfeeding. We also read the topics about Abilify on this forum.

    We know the benefits of breastfeeding and planned to do so until a meeting with our midwife a few days ago, who totally forbade us to breastfeed with Abilify. Her telling was based on the reference database here in France, the CRAT (Research Center for Teratogenic Agents). It says that it is "better to avoid breastfeeding" with Abilify [1], which sounds less favorable that the L3-Limited Data-Probably Compatible rating on Dr Hale's scale. The pediatrician returned the same verdict as the midwife, arguing that Abilify may cause somnolence to the baby, leading to possible respiratory problems and a possible death.

    We are trying to weigh the pros and cons (once more!), and find the best compromise. No breastfeeding at all seems like overreacting. We would like to have your advices on the best practices we could apply. Is there any advantage to give only one or two nursing bottles of breastmilk a day, the rest being infant formula? Does it even lower the risks (is the risk dose dependent? - my wife's dose is quite low, 2.5 mg/day, and she could breastfeed as far as possible from her intake)? How high is the sleepiness risk at this dose? Or should we maximize breastfeeding in the first days or weeks then slowly stop?

    We would be glad if you could share your points of view.

    Thank you


    [1] [url]https://lecrat.fr/spip.php?page=article&id_article=294[/url] (in French)
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