Hi Sue On annual leave so dont have all my reference material.... but from what I do have, it is possible to breastfeed whilst on Lithium as long as the infant is monitored closely for signs of toxicity as lithium passes into breastmilk. Monitoring would include behavioural and chemical changes. If infant lithium become an issue, then use of milk banking from donors is a helpful alternative until levels settle. From memory, Lithium does not seem to interfere with the onset and maintenance of lactation so comp feeding should not be needed and will only interfere with continuation of supply. Hale in 'Medications & Mothers Milk, 2002' places Lithium during pregnancy at a Category D risk- where there is positive evidence of fetal risk, but benefits to the mother may be acceptable despite the risk and for lactation at a L4 risk - where there is positive evidence of risk to the breastfed infant but benefits from use in the mother may be acceptable despite infant risk. He also states that current published and unpublished experience suggest that infant plasma levels rise to about 30-40% of maternal levels, mostly without untoward effects in the infant. He suggest that Lithium does not reach steady state levels for approximately 10 days and that it may be of benefit to wait this long prior to evaluating infant levels (unless symptoms appear earlier). He also reminds clinicians that Lithium has been shown to interfere with thyroxine production and periodic thyroid function evaluation are suggested
Hope this is helpful Cheers Alesa Alesa Koziol Clinical Midwifery Educator Melbourne ----- Original Message ----- From: "Sue Cookson" <[EMAIL PROTECTED]> To: <ozmidwifery@acegraphics.com.au> Sent: Saturday, January 06, 2007 8:59 AM Subject: Re: [ozmidwifery] birth and mental health > Thanks Alesa. > Can you share the thoughts you had about what other choices you know to > be available to women on Lithium? > Particluarly interested in breastfeeding ... > > The woman I am seeing has no issues about her ability to cope with > motherhood and is very well supported - just trying to work through the > options re place of birth, level of back-up, breastfeeding - if so would > comp feeding or milk banking be necessary/beneficial? > > Thankyou, > > Sue > > >HI Sue > >Recently worked with a woman who has been on Lithium for many years. > >Pregnant with her first and on advice had chosen to remain on this > >throughout pregnancy and also chose not to breastfeed and quite happy with > >this decision as she wanted to stay 'stable & normal' (her words). Following > >birth we kept a close eye on the infant for any signs of toxicity- there > >were none and they went home after an uneventful hospital stay.When I last > >caught up with five weeks after birth, she was really pleased with her whole > >pregnancy/birthing/parenting (so far) experience. Especially pleased with > >her ability to care for her infant as she had severe doubts about this prior > >to birth. Reflecting on her experience I see many areas where I would have > >made different choices, but was once again was reminded that the journey > >truly is for each woman to make her own > >Cheers (and congratulations) > >Alesa > > > >Alesa Koziol > >Clinical Midwifery Educator > >Melbourne > >----- 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 > >>-- > >>This mailing list is sponsored by ACE Graphics. > >>Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > >> > >> > > > >-- > >This mailing list is sponsored by ACE Graphics. > >Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > >__________ NOD32 1.1454 (20060321) Information __________ > > > >This message was checked by NOD32 antivirus system. > >http://www.nod32.com > > > > > > > > > > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
