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Pregnancy & Nursing while on Lithium [posted 10/2/98]
Question: I have bipolar disorder that responds very well to Lithium, 1200mg/day. I recently gave birth to my third child (on 6/21/98). I do not take Lithium during my pregnancy and I feel wonderful (very euthymic) pregnancy seems to be "protective" for me. However, I always have problems in the postpartum period. I want to breastffeed so I do not resume Lithium after delivery.. Now I am 8 weeks postpartum and having hypomanic symptoms (pressured speech, flight of ideas, extreme irritability and emotional lability, difficulty falling asleep) and I know it is time to start lithium. My question: what percent of the plasma concentration of lithium is secreted in breast milk? The PDR says only that lithium is secreted and discourages nursing an infant while on it, but does not elaborate. I would very much like to continue nursing, if only twice a day. Is there any new information on the risks of lithium to the nursing infant?

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