Hi Sue -I have vivid memories of a mum who came off lithium so she would be
able to breastfeed- went into psychosis and didnt even recognise her bub. It
was years ago .
According to Hale(Medications in mothers milk. 11th edition) - lithium is
generally increased (dosage) during preg due to increased renal clearance .
After birth, levels need to be closely monitored as mother's renal clearance
drops to normal. Several cases of lithium toxicity have been reported in
newborns. According to Hale, breastfeeding is not necessarily
contraindicated as long as babys levels are monitored and there are no
symptoms of toxcicity but other anti manic drugs such as valproate may be a
better option for breastfeeding mums. Of course this depends how confident
the woman is re changing meds if the lithium is effective and balanced for
her.
Living with a family member on lithium ( male so not giving birth) the sad
thing I have observed is that as people with mental illness become unwell
they lose the insight that would tell them they were becoming unwell and so
tend to blame others around them to rationalise their symptoms. I would
suggest the woman and her partner/ family member give you a list of 'early
warning signs' of her illness before she has her bub and that she keeps in
good contact with her psychiatrist throughout pregnancy and postpartum. Home
birth may be much better than hospital as she will be in familiar
surroundings so will be monitored by loved ones who know her well and not
treated with 'kid gloves' for what may well be 'normal' postpartum mood
changes. Except of course that severe mania can happen very quickly and be
very scary for everyone around to contain. What would be their plan if she
became unwell? Get them to write this as they woudl a birth plan.
Pinky
----- Original Message -----
From: "Sue Cookson" <[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Wednesday, January 03, 2007 6:03 PM
Subject: [ozmidwifery] birth and mental health
Hi,
Do any of you have stories relating to the use of Lexapro and Lithium (two
different women) and birth - particularly homebirths.
Would appreciate any feedback re outcomes and neonatal well being.
Also how the women manage their medication both pre and post birth.
As usual there is a lot of info out thereand a lot of it conflicting,
Thanks,
Sue
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