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redcanary 08-04-2014 12:13 PM

Weaning because of a medication? Help/support please
Hello everyone-

I have a 22 month old daughter who I am still breastfeeding quite a lot - or had been until last week when I had to be hospitalized for a manic episode of bipolar disorder. I had never been away from her for more than 2 hours before now, it's been really hard for all of us to be separated suddenly like this. The LC on the maternity floor came and brought me a pump and bottles and offered her support. I have been safely taking a medication called lamotrigine all through pregnancy and nursing so far, but because of the mania the doctors here have added lithium to slow me down. There isn't much research done about lithium and breastfeeding, and what little research exists is mostly of infants who have also been exposed to lithium in utero as well. It does pass to breastmilk, and can accumulate in babies, from the studies I've read the serum level in babies is about 10-17% of the mother's level. Only a couple of newborns in the studies had any serious side effects, and they were exposed during pregnancy. Most of the babies had no adverse reactions.

So. I haven't found any information about toddlers being exposed to lithium suddenly, and they titrate up the level slowly in me, so I am not sure how quickly it builds up in breastmilk, and I'm not sure how quickly it is building up in my daughter. For the last week I have been pumping a few times a day, and then nursing a LOT for several hours of the daily visiting time. She is fine so far and I am asking about having her blood taken to be tested.

The doctors, my husband, and I are all a little nervous about my continuing to breastfeed her. There just isn't much evidence of what the possible effects might be for her. She doesn't nurse as much as a newborn, she doesn't get as much milk as a newborn, and is much larger and eats lots of food. They asked me this morning how important it is to me that I continue to nurse my toddler. I am feeling really upset and heartbroken about this - and I know how important it is to my daughter as well - but I also know how important it is for me to be on medication that keeps me a sane functional mother.

This is a really hard thing for me to think about, it all happened so suddenly and I had planned to nurse her for as long as she wanted to - I didn't want to stop suddenly like this. If I can keep nursing safely I will, but I just don't know.

I feel like all the doctors in there who have never nursed a baby/toddler just don't really know what it's like, how important it is, what the bond is like and how special it is and how difficult it would be for my daughter and I to suddenly break that. Not to mention the hormonal/emotional effects of discontinuing breastfeeding.

I am really upset and torn, which are not good feelings for me to be having as I'm feeling a bit fragile right now, coming down from a seriously intense emotional break.

So, I guess ultimately I just wanted some online hugs from women who understand what a loss it would be for us to stop - maybe some encouragment to keep at it if I can - and maybe some what-would-you-do advice as well.

Thank you all in advance, I really need the support.

pokeyac 08-05-2014 11:09 AM

I'm sorry you are facing a tough decision and health issues. :Hug
Have you checked with the Infant Risk Center? You can also call 806-352-2519. They have a "Probably Safe" rating for lithium at an age of after 12 months. I would definitely look into it.
Weaning will be emotionally hard for you and probably your daughter, and if you are already having a hard time, this could make it harder. Taking care of yourself comes first. You can't be a good mom if you are not healthy. Deciding to wean is up to you, but make sure you have some good info first. Many doctors do not know a lot about medications and breastfeeding and will recommend weaning to be safe. If you do decide to wean, doing it gradually may be better for both of you. I understand what a loss it would be to you to stop nursing. I would be torn too. I am looking at weaning my son in the next few months and it makes me sad too. I will miss the time we spend cuddling and giving him perfect nutrition.

redcanary 08-07-2014 01:30 PM

Thank you so much. I contacted the Infant Risk people and they got back to me very quickly and gave me good information!

I think when I go home from the hospital I will work on slowly and gently weaning her. While I am reassured that the medicines I take can be safe for her, I'd rather she wasn't exposed to any of it for too long, because especially the lithium can be accumulative. I don't want to do it suddenly, it would be much too stressful for both of us, not to mention the hormone drop.

Thanks again.

pokeyac 08-07-2014 01:36 PM

I'm so glad they were able to help you and that you have a plan that feels good to you. I totally understand not wanting to put your daughter at risk. I hope the gentle weaning goes well and you are feeling better and balanced.

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