Archives of Women's Mental Health

, Volume 15, Issue 1, pp 69–72 | Cite as

Three cases of lithium exposure and exclusive breastfeeding

  • Debra L. BogenEmail author
  • Dorothy Sit
  • Adrienne Genovese
  • Katherine L. Wisner
Short Communication


The aim of this study was to provide data to aid decision making regarding lithium use during lactation. Three women treated with lithium for bipolar disorder during pregnancy and lactation and their four infants provided lithium levels at 1 month postpartum. Infant levels ranged from 10% to 17% of maternal levels. Two infants experienced early feeding problems which were overcome with breastfeeding education and support. Women taking lithium can be supported to breastfeed, and their infants should be followed closely until breastfeeding is well established.


Lithium Breast milk Lactation Bipolar disorder 



We would like to thank Elizabeth Nuhfer for coordinating laboratory specimen processing and analysis, to our clinicians who evaluated these mothers, and to the women who participated.


  1. Agency for Healthcare Research and Quality (2007) Breastfeeding and maternal and infant health outcomes in developed countries. From Accessed 8 June 2011
  2. American Academy of Pediatrics Section on Breastfeeding (2005) Breastfeeding and the use of human milk. Pediatrics 115(2):496–506CrossRefGoogle Scholar
  3. Drug and Lactation Database (LactMed) (2011). Lithium, US National Library of Medicine.Google Scholar
  4. Ip S, Chung M, et al. (2007) Breastfeeding and maternal and infant health outcomes in developed countries. Evidence Report/Technology Assessment No. 153 (Prepared by Tufts-New England Medical Center Evidence-based Practice Center, under Contract No. 290-02-0022). AHRQ Publication No. 07-E007. Rockville, MD.Google Scholar
  5. Kozma C (2005) Neonatal toxicity and transient neurodevelopmental deficits following prenatal exposure to lithium: another clinical report and a review of the literature. Am J Med Genet 132A:441–444CrossRefGoogle Scholar
  6. Moretti ME, Koren G et al (2003) Monitoring lithium in breast milk: an individualized approach for breast-feeding mothers. Ther Drug Monit 25(3):364–366PubMedCrossRefGoogle Scholar
  7. Moses-Kolko EL, Bogen D et al (2005) Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications. JAMA 293(19):2372–2383PubMedCrossRefGoogle Scholar
  8. Newport DJ, Viguera AC et al (2005) Lithium placental passage and obstetrical outcome: implications for clinical management during late pregnancy. Am J Psychiatry 162(11):2162–2170PubMedCrossRefGoogle Scholar
  9. Skausig O, Schou M (1977) Breast feeding during lithium therapy. Ugeskr Laeger 139(7):400–401PubMedGoogle Scholar
  10. Tanaka T, Moretti ME (2008) A pitfall of measuring lithium levels in neonates.[Erratum appears in Ther Drug Monit. 2009 Feb;31(1):137]. Ther Drug Monit 30(6):752–754PubMedCrossRefGoogle Scholar
  11. Towle A, Godolphin W (1999) Framework for teaching and learning informed shared decision making. Br Med J 319(7212):766–769CrossRefGoogle Scholar
  12. Tunnessen W, Hertz C (1972) Toxic effects of lithium in newborn infants: a commentary. J Pediatr 81:804–807PubMedCrossRefGoogle Scholar
  13. US Department of Health and Human Services (2011) The surgeon general's call to action to support breastfeeding. Washington, DC, US Department of Health and Human Services, Office of the Surgeon GeneralGoogle Scholar
  14. Viguera AC, Newport DJ et al (2007) Lithium in breast milk and nursing infants: clinical implications. Am J Psychiatry 164(2):342–345PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Debra L. Bogen
    • 1
    • 2
    • 3
    Email author
  • Dorothy Sit
    • 2
  • Adrienne Genovese
    • 2
  • Katherine L. Wisner
    • 2
  1. 1.Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghUSA
  2. 2.Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghUSA
  3. 3.University of Pittsburgh School of MedicineDivision of General Academic PediatricsPittsburghUSA

Personalised recommendations