Continuing drug therapy while breastfeeding. Part 2. Common misconceptions of physicians.
OBJECTIVE
Is there any way to predict whether a drug taken by a mother is safe for a suckling baby, or is it just trial and error? One of my patients is receiving lithium for manic depression. She wishes to breastfeed, but clinically there is no way she can discontinue the drug. My sources say the drug is incompatible with breastfeeding.


CONCLUSIONS
The amount of drug available to a baby through breastmilk is estimated as the percentage of maternal dose per kg ingested by the baby. Because infants' clearance rate of many drugs is slower than adults', however, the true level of the drug circulating in the infant's blood might be much higher. Because lithium can be measured in plasma, it is prudent to measure it in milk and to estimate the "baby dose." If a baby shows any adverse effects, lithium levels should be measured in its blood.
Koren
G
G
University of Toronto.
Moretti
M
M
Ito
S
S
D000328:Adult; D000367:Age Factors; D001714:Bipolar Disorder / Q000188:drug therapy; D001942:Breast Feeding; D016903:Drug Monitoring; D004358:Drug Therapy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008094:Lithium / Q000032:analysis* / Q000097:blood* / Q000627:therapeutic use; D008895:Milk, Human / Q000737:chemistry*; D008954:Models, Biological
D008094:Lithium