Q: Medications and Breastfeeding
I am bi polar. I recently had twins and I was able to
brestfeed them for 6 weeks, but now I am in a state of mania and the
medications my doctor is suggesting would make me have to stop breastfeeding,
which I don't want to do. Do you know of any medications that I could
take and continue breastfeeding?
Dear Melissa --
The American Academy of Pediatrics has okayed Depakote for use while
breastfeeding. Some experts think that was based on too little
information and aren't quite so sure it's okay. We know lithium is not
okay, and as for the rest of the medications we usually consider, there is
even less information to go on than for Depakote. You will see Tegretol
on some lists as okay; it has also been approved by the AAP but surfing around
today I find more skepticism about it's safety than with Depakote. I
fear the problem here, as regards these different opinions, is just too little
information to go on.
Sometimes we use low doses of the new generation of
antipsychotic medications for manic symptoms, but these too have not been
tested (checked a literature search on that; e.g. see this
summary). The old generation antipsychotics like Haldol are listed
as "probably okay", particularly at low doses.
Congratulations on your new family members, and for
having been able to get at least 6 weeks breastfeeding with them. Your
choice now is a difficult one. Your doctor may have already considered
all the options, and their risks and benefits; you could ask for a further
discussion, and I hope you could get one. I'm sorry not to be able to be
more specific about all this. Good luck to you and your kiddos.
Published August, 2001