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Recommendations made
pediatrician - Dr. Victоr Аbdоw
Rоckville, МD, USА.


woomen

Is it allowed to take Lithium Citrate during lactation?
Is it safe for a nursing mother and a child?

It is excreted into breast milk in amounts that may be clinically significant and can be as high as a half of that reached in mother’s plasma and up to one third of the therapeutic level in the infant. In infants and newborns (5 days), premature babies and dehydrated or infected infants, who may show reduced clearance mechanisms for lithium, there have been reports of clear signs of lithium toxicity caused by ingestion of breast milk: cyanosis, lethargy, hypotonia or slight increase in TSH. However, there are numerous cases of infants whose mothers were on lithium who did not show any clinical, growth or neurodevelopmental problem at the short or long term. Breastfeeding is less risky for healthy term infants whose mothers are treated with lithium when she or her family has capacity enough to monitor the occurrence of adverse effects, medical supervision and, whenever necessary, monitoring of lithium levels in the mother-infant dyad. Mothers should stop taking lithium 1 to 2 days before delivery or cesarean section in order to decrease plasma levels in the newborn. Lithium may be, or not, a cause of increased Prolactin and galactorrhea.

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woomen

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Types of risk

VERY LOW RISK
It is allowed while breastfeeding. It is not dangerous for a baby. It is moderately safe. more...

LOW RISK PROBABLE
Possible presence in breast milk is allowed. Follow the doctor's recommendation. more...

HIGH RISK PROBABLE
An unsafe drug, it is necessary to assess the risks while taking. Use safer analogs. more...

VERY HIGH RISK
It is not recommended. You need to stop breastfeeding or choose a safe analog. more...

Scientific literature

The level of risk for breastfeeding is confirmed in these scientific publications:
  1. http://www.ncbi.nlm.nih.gov/pubmed/26781551
  2. http://www.ncbi.nlm.nih.gov/pubmed/27297617
  3. http://www.ncbi.nlm.nih.gov/pubmed/27568278
  4. http://www.ncbi.nlm.nih.gov/pubmed/26330649
  5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539876/
  6. http://www.ncbi.nlm.nih.gov/pubmed/26344706
  7. http://www.ncbi.nlm.nih.gov/pubmed/25352315
  8. http://www.ncbi.nlm.nih.gov/pubmed/26648652
  9. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657301/pdf/austprescr-38-156.pdf
  10. http://www.ncbi.nlm.nih.gov/pubmed/26204124
  11. https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/18-use-of-antidepressants-protocol-english.pdf
  12. http://www.ncbi.nlm.nih.gov/pubmed/23979084
  13. http://pediatrics.aappublications.org/content/132/3/e796.full.pdf
  14. http://www.ncbi.nlm.nih.gov/pubmed/23178070
  15. http://www.ncbi.nlm.nih.gov/pubmed/22283766
  16. http://www.ncbi.nlm.nih.gov/pubmed/22787503
  17. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394379/pdf/Dtsch_Arztebl_Int-109-0419.pdf
  18. http://www.ncbi.nlm.nih.gov/pubmed/22277970
  19. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629811/pdf/nihms-459835.pdf
  20. http://www.ncbi.nlm.nih.gov/pubmed/20958101
  21. http://www.ncbi.nlm.nih.gov/pubmed/21267028
  22. http://tidsskriftet.no/pdf/pdf2011/126-9.pdf
  23. http://www.ncbi.nlm.nih.gov/pubmed/21420368
  24. http://www.ncbi.nlm.nih.gov/pubmed/21267028
  25. http://www.ncbi.nlm.nih.gov/pubmed/21420368
  26. http://www.ncbi.nlm.nih.gov/pubmed/19453201
  27. http://www.ncbi.nlm.nih.gov/pubmed/19884236
  28. http://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2009.08121902
  29. http://www.ncbi.nlm.nih.gov/pubmed/19057375
  30. http://www.ncbi.nlm.nih.gov/pubmed/17267800
  31. http://ajp.psychiatryonline.org/doi/pdf/10.1176/ajp.2007.164.2.342
  32. http://www.ncbi.nlm.nih.gov/pubmed/16910623
  33. http://www.ncbi.nlm.nih.gov/pubmed/15591613
  34. http://www.ncbi.nlm.nih.gov/pubmed/12766565
  35. http://whqlibdoc.who.int/hq/2002/55732.pdf
  36. http://www.ncbi.nlm.nih.gov/pubmed/11527233
  37. http://www.ncbi.nlm.nih.gov/pubmed/11013791
  38. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2145042/pdf/canfamphys00031-0055.pdf
  39. http://www.ncbi.nlm.nih.gov/pubmed/10732654
  40. http://www.ncbi.nlm.nih.gov/pubmed/10840214
  41. http://www.ncbi.nlm.nih.gov/pubmed/10738733
  42. http://www.ncbi.nlm.nih.gov/pubmed/10221361
  43. http://www.ncbi.nlm.nih.gov/pubmed/10349056
  44. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2328598/pdf/canfamphys00039-0055.pdf
  45. http://www.ncbi.nlm.nih.gov/pubmed/10084341
  46. http://www.ncbi.nlm.nih.gov/pubmed/9512921
  47. http://www.ncbi.nlm.nih.gov/pubmed/9674938
  48. http://www.ncbi.nlm.nih.gov/pubmed/9732101
  49. http://www.ncbi.nlm.nih.gov/pubmed/9441422
  50. http://www.ncbi.nlm.nih.gov/pubmed/7834964
  51. http://www.ncbi.nlm.nih.gov/pubmed/1818576
  52. http://www.ncbi.nlm.nih.gov/pubmed/2211538
  53. http://www.ncbi.nlm.nih.gov/pubmed/2666104
  54. http://www.ncbi.nlm.nih.gov/pubmed/3099894
  55. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1342181/pdf/bmjcred00263-0029.pdf
  56. http://www.ncbi.nlm.nih.gov/pubmed/6147939
  57. http://www.ncbi.nlm.nih.gov/pubmed/6411540
  58. http://www.ncbi.nlm.nih.gov/pubmed/7330110
  59. http://www.ncbi.nlm.nih.gov/pubmed/895996
  60. http://www.ncbi.nlm.nih.gov/pubmed/841726
  61. http://www.ncbi.nlm.nih.gov/pubmed/1000200
  62. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1689987/pdf/brmedj00545-0029a.pdf
  63. http://www.ncbi.nlm.nih.gov/pubmed/4699592
  64. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1589236/pdf/brmedj01553-0024.pdf
  65. http://www.ncbi.nlm.nih.gov/pubmed/5074360
  66. http://www.ncbi.nlm.nih.gov/pubmed/5369134

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