When and how to use mood stabilizers during breastfeeding.
For many women with bipolar disorder, treatment with mood stabilizers is indicated to decrease the risk of a recurrence of depression, mania, or psychosis during the postpartum period. Because breastfeeding during this time exposes infants to these medications, a risk-benefit analysis is crucial for the mother and her physician when deciding whether to breastfeed. This article reviews the risks and benefits to mothers and nursing infants with regard to untreated mental illness, breastfeeding, and medication exposure during breastfeeding. Reports of breast milk and infant serum drug concentrations are summarized. Adverse events reported with lithium, valproate, and carbamazepine are also described. The current available data and their limitations are further summarized to allow physicians to assess more accurately the risks and benefits of the use of mood stabilizers during breastfeeding. Finally, a list of practical recommendations is provided.
Chaudron
LH
William S Middleton Memorial Veteran's Administration Hospital and University of Wisconsin Medical School, Madison, Wisconsin, USA