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Member Research & Reports

Member Research & Reports

Northwestern: Safe to Breastfeed on Bipolar Medication? Jury Still Out.

Women taking lithium to treat their bipolar disorder frequently ask if breastfeeding while on the medication will harm their babies. Those fears are largely rooted in sparse studies that have not addressed critical factors, reports a new Northwestern Medicine systematic review.

The review was published June 10 in the International Review of Psychiatry.

The mood stabilizer lithium is the gold standard of care for treating bipolar disorder, which affects an estimated 22 million women worldwide. Itis effective at preventing manic episodes and postpartum psychosis but some experts advise against taking lithium while breastfeeding because of concerns that it will transfer to the breast milk and potentially be toxic to the baby.

Prior to 2000, research on the effects of lithium exposure through breast milk were retrospective and lacked standardization, such as not including control groups and not considering the health of the mother or her infant or the other medications the mother was taking, the review found. Studies after 2000 were better designed and suggest that lithium is low risk during breastfeeding. Still, more research is needed, the authors said.

“This is a highly controversial topic, and expert recommendations vary, but the truth is it’s 2019, and we still don’t have the evidence to back up any of the fears about lithium use and breastfeeding,” said senior author Dr. Crystal Clark, assistant professor of psychiatry and behavioral sciences and obstetrics and gynecology at Northwestern University Feinberg School of Medicine and a practicing Northwestern Medicine psychiatrist.

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