lamictal and breastfeeding?

[Black Orchid]

Hi everyone...

I am a bipolar mom to a 3.5 mo and an (almost) 3 yo. Both are nurslings. Anyway, I have been having major cycling problems with my bipolar depression and am currently weaning myself off Lexipro which I was able to take while pregnant and nursing. The next step is to begin more heavy-duty drug therapy because nothing else is working. Trust me when I say that I've tried everyhitng... different diets, combination of anti depressants, doing nothing...

Does anyone know about lamictal and nursing? I have the 2006 revision of MMM by Dr. Hale, but it doesn't really address the side effects stated by the manufacturer... just gives the expected transfer rate and that in the few cases he's seen that there hasn't been any problems in infants.

Does anyone here have access to any more detailed info? I really, really, really do not want to wean my 3.5 month old. I worked so hard to nurse my older dd and was planning to clw both. I am committed to nursing, but without any further info, showing the safety of nuring on this drug I'm going to have to wean her. I don't feel safe with the info that I've found. Please, please, please help me!

Thanks.

[jorie]

Well, you posted this a million years ago, so maybe you found your answer, but here goes anyway. . . I am an epileptic and have taken lamictal (300mg/day) through two pregnancies and nursed both kids, still nursing ds2 actually. I have noticed no side affects whatsoever in my kids. Ds1 is 4yo now and is above average in height, extremely verbal and social, and I get asked all the time if he is 5 or 6yo because of his behavior and size. Ds2 is 19mo also very healthy and above average in height/development. From my own experience, I see no reason why you shouldn't take it.

[figandme]

lamictal and pregnancy

Hi Jorie, I found your post while looking for ways to wean myself off of Lamictal so that I could get pregnant. My pshychiatrist (I'm bipolar) said that there weren't any effects on unborn babies when the mother took Lamictal, but my OB says that there is a risk of cleft lip/palette and to not breastfeed while on it. This has put a end to us trying to conceive now. Were you given any of this information or did you experience any negative side effects? I would really like to start trying again, but I'm weary of going off the Lamictal. Please let me know your experiences with it.
Thanks,
Molly

[jorie]

Originally Posted by jorie

I have noticed no side affects whatsoever in my kids. From my own experience, I see no reason why you shouldn't take it.

So, no. And no, offense, but I have had such bad experiences with OBs, that I take anything any OB says with a truck load of salt! I would switch OBs, switch to a Family Dr. or to a midwife before I would go off the Lamictal, if it is working for you! My neurologist is the head of the neurology dept at Mayo Clinic, Rochester, MN. His research (ie life's work) is in epilepsy in women, specifically women of child-bearing age so he has loads of experience with pregnant/nursing women. Lamictal is the drug he put me on before I had kids, knowing I was of child-bearing age, and kept me on when I was pregnant and nursing. My first born was a preemie and the NICU drs at Mayo didn't tell me to not nurse him. In fact, they specifically said that the benefits of breastfeeding outweighed the possible side-effects of the lamictal. Generally speaking, the side-effect to be concerned about with Lamictal is a rash and if you have this rash, you're not suppose to take it. And if the baby gets the rash from the lamictal through breastmilk, then you're not suppose to take it. Other than that . . .I haven't heard the cleft lip/palatte thing, but that is very fixable and if Lamictal controls your disorder and the baby suffers no other effects . . .? You have to do a cost/benefit analysis. How risk acceptant are you? Is there another drug with lower known effects that will control your symtoms as well as the Lamictal? For me, my kids are safer with a bit of Lamictal in their system than they would be with a seizing mom! And unless you are on a high dose of Lamictal, your child is still better off getting the "perfect" food of breastmilk and a bit of Lamictal, than the garbage that comes in a can! There are only potential risks for a baby getting Lamictal in breastmilk BUT there are KNOWN risks for a baby getting artificial baby milk. Oh, and taking a large dose (1-4mg) of folic acid is known to mitigate birth defects

[prettyclever]

Jorie, thank you so much for your words. I already feel better!!! My husband and I had our first psychiatrist appt. yesterday to discuss getting pregnant. I wanted all the info before we even thought about starting a family. I have been diagnosed with bipolar for about 10 years and have been on everything there is. I am on lithium and seroquel right now and the doctor wants me to take Lamictal instead (I have been on lamictal before and liked it okay, though i felt sick to my stomach all of the time) My concern is being on this drug the whole pregnancy and somehow hurting my baby. She did not sound the least bit concerned with the risks. She said 68% of women who aren't on meds during the pregnancy will have manic episodes and that can cause major problems. I guess I am just worried about the first trimester. I need to hear a bunch of women say "I did it, I was on Lamictal my entire pregnancy and my baby is healthy, I made the right choice"

[jorie]

Originally Posted by prettyclever

Jorie, thank you so much for your words. I already feel better!!! My husband and I had our first psychiatrist appt. yesterday to discuss getting pregnant. I wanted all the info before we even thought about starting a family. I have been diagnosed with bipolar for about 10 years and have been on everything there is. I am on lithium and seroquel right now and the doctor wants me to take Lamictal instead (I have been on lamictal before and liked it okay, though i felt sick to my stomach all of the time) My concern is being on this drug the whole pregnancy and somehow hurting my baby. She did not sound the least bit concerned with the risks. She said 68% of women who aren't on meds during the pregnancy will have manic episodes and that can cause major problems. I guess I am just worried about the first trimester. I need to hear a bunch of women say "I did it, I was on Lamictal my entire pregnancy and my baby is healthy, I made the right choice"

Glad I could offer some reassurance. What dose do they put you on for bipolar? I've always assumed it would be lower than for epilepsy . . . .
So it has been two years since my above post and ds2 has weaned (but only 4 months ago). Ds1 is 6 1/2, still very bright and social, in the top reading group for his grade and continuing to show no ill affects from his exposure to Lamictal. Likewise, at 3yr 9mo old, ds2 is a generally happy, self-assured little boy with a fabulous sense of direction and no indications of having suffered harm because of his exposure to Lamictal. I am TTC #3 and still no medical person in my life is concerned about the Lamictal. Based on my experience with two kids, I'd say go for it.

[vontsi]

Thank you Jorie

Hi Jorie,

I am so glad to read about your breastfeeding and pregnancy experience with Lamictal!

I am planning for my 2nd pregnancy. My neuro has advised me to wean my 1-yr-old girl off as he switched my medication from Epilim to Lamictal, in prep for the pregnancy. He said Lamictal is still quite new, not many studies on its effects on nursing babies. I was so reluctant to wean her and have not done so.

I have not even switched my medication til now. I wanted to find out more. Thank goodness I chanced upon your post. It made me feel reassured to continue to breastfeed even on Lamictal (given dose: 150mg a day).

I would like to know - did you nurse your 1st child throughout your 2nd pregnancy?

[jorie]

Originally Posted by vontsi

Hi Jorie,

I am so glad to read about your breastfeeding and pregnancy experience with Lamictal!

I am planning for my 2nd pregnancy. My neuro has advised me to wean my 1-yr-old girl off as he switched my medication from Epilim to Lamictal, in prep for the pregnancy. He said Lamictal is still quite new, not many studies on its effects on nursing babies. I was so reluctant to wean her and have not done so.

I have not even switched my medication til now. I wanted to find out more. Thank goodness I chanced upon your post. It made me feel reassured to continue to breastfeed even on Lamictal (given dose: 150mg a day).

I would like to know - did you nurse your 1st child throughout your 2nd pregnancy?

Gosh! That is 1/2 the dose I take! I would sooooo not be worried, if I were you. I didn't nurse ds1 throughout my 2nd pregnancy but this is because my milk dried up in my 2nd trimester and I found "dry" nursing to be excruciating! Ds1 wasn't nursing much anymore, sometimes going a couple days without. I just wasn't up for "practicing my labor breathing" through the pain, like some people suggest! Hey, if that works for some, go for it! But it wasn't for me. If your daughter is nursing more frequently, it reduces the chances of your milk drying up, but it is fairly common for milk to dry up in the 2nd trimester in preparation for colostrum to start forming in the 3rd trimester. That said, I have a friend who has nursed through 5 pregnancies and at least once was nursing two and pregnant! I would suggest you read "Adventures in Tandem Nursing" by Hilary Flowers. It has great stuff about nursing through pregnancy. Feel free to pm me if you have more questions.

[vontsi]

Originally Posted by jorie

Gosh! That is 1/2 the dose I take! I would sooooo not be worried, if I were you. I didn't nurse ds1 throughout my 2nd pregnancy but this is because my milk dried up in my 2nd trimester and I found "dry" nursing to be excruciating! Ds1 wasn't nursing much anymore, sometimes going a couple days without. I just wasn't up for "practicing my labor breathing" through the pain, like some people suggest! Hey, if that works for some, go for it! But it wasn't for me. If your daughter is nursing more frequently, it reduces the chances of your milk drying up, but it is fairly common for milk to dry up in the 2nd trimester in preparation for colostrum to start forming in the 3rd trimester. That said, I have a friend who has nursed through 5 pregnancies and at least once was nursing two and pregnant! I would suggest you read "Adventures in Tandem Nursing" by Hilary Flowers. It has great stuff about nursing through pregnancy. Feel free to pm me if you have more questions.

Thank you once again for your reassurance! I can start taking Lamictal then. I am still trying for my 2nd child. Dare not 'do' much as I have yet to switch over to Lamictal. Currenly on Epilim and my neuro told me to hold til the last ouce of it gets 'flushed' out of my body system by Jan next yr. By right, I should only start trying next Feb to 'play it safe' to minimise any birth defects possibly caused by Epilim.

Really glad to know someone like you across the ocean.. I will definitely seek your opinion when the opportunity arises given your experiences! Will search for the book you recommend on nursing. I hope I can nurse as long as I can.. definitely love the special bond I share with my Princess.:

[jorie]

Originally Posted by vontsi

Thank you once again for your reassurance! I can start taking Lamictal then. I am still trying for my 2nd child. Dare not 'do' much as I have yet to switch over to Lamictal. Currenly on Epilim and my neuro told me to hold til the last ouce of it gets 'flushed' out of my body system by Jan next yr. By right, I should only start trying next Feb to 'play it safe' to minimise any birth defects possibly caused by Epilim.

Really glad to know someone like you across the ocean.. I will definitely seek your opinion when the opportunity arises given your experiences! Will search for the book you recommend on nursing. I hope I can nurse as long as I can.. definitely love the special bond I share with my Princess.:

It seriously takes a year to get off the Epilim? Wow! Do you know what dose of lamictal you will end up on? I know when I switched from depakote (a similar drug to epilim) to lamictal there was a weaning-off weaning-on process but it seems like that only took a couple weeks (this was 8 years ago). I do know high dose folic acid helps mitigate birth defects. My neuro asks me like 10 times if I am taking it everytime I see him. Oh, one thing you should know--lamictal is sensitive to progesterone which means I have to up my meds a tad when I am pregnant, like 50mg/day. Good luck!

ETA lamictal is almost 20 years old, so really not a "new" drug.