To Breastfeed or Not to Breastfeed?

When searching for answers regarding lithium and breastfeeding I came a across a single study; a single study with 10, yes 10, mother-infant pairs! Needless to say making a sound decision to breastfeed was very difficult.

Although the sample size in the study (through MGH) was small, it is the largest systematic study quantifying exposure of lithium in children through breastfeeding. "While early reports raised concerns regarding exposure to high levels of lithium in nursing infants, this study suggests that lithium levels in infants are relatively low and were about 25% of maternal levels" (MGH, 2005). There was insufficient data regarding long-term effects of in utero exposure to mood stabilizers. In the same way there is limited long-term data regarding mood stabilizers and breastfeeding.


Sleep interruption was a major concern of mine/ours. Sleep is central to maintaining mood and stress levels with any mental illness. If we choose to breastfeed there would be a need for regular clinical monitoring for both myself and the infant. And of course there were more side effects to consider. The infant could experience a range of side effects from my medication including lithium toxicity, low muscle tone an difficulty feeding.

In the end we opted to NOT add on side effects to potential side effects. My medical condition had already impacted the baby physically and emotionally in utero. Exposing the baby to further psychotropic medication seemed unnecessary and excessive. Two of my children have been formula fed. They both took to basic formula right away without issue.

Breastfeeding is best. All women know this well. I have been judged on a few occasions for my decision to formula feed my children. It was a tough decision not to breastfeed, just as it was a tough decision to maintain treatment during pregnancy. It's important to reserve judgement, and accept that not all decisions are automatic and organic. I'm grateful for formula and the benefits it has brought my whole family. Bottle on moms!


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