Breastfeeding with bipolar.

[JessSMBC]

Hi everyone, I am on a journey to become a single mum by choice this year. And I have made the decision to breastfeed my baby. I was wondering if anyone has experience breastfeeding has a person managing their bipolar with medication.

Hello, I breastfeed my daughter until 10 months whilst bipolar.
I did have an episode post partum and the perinatal team were very supportive in trying to keep me on medication that was safe to breastfeed on. I was on quetiapine in pregnancy and then mirtazapine, sertraline and citalopram were tried to control the episode. This didn't work and I needed to be admitted to a mother and baby unit. The last ditched attempt was venlafaxine but they weren't really happy with me being on this due to risk of mania. I was struggling to get my daughter to take a bottle which was a compounding problem

We did manage to get her to take a bottle and I switched to lithium and she went on to formula as it's not recommended to breastfeed on lithium. They later added lamotrigine and this too wouldn't have been possible whilst breastfeeding.

I'm pregnant again and back on just quetiapine. They are supportive of me breastfeeding but I have had to acknowledge that the game changer last time was the lithium so it's likely that if I become unwell again that they will want me to go back on lithium and stop breastfeeding to avoid another admission to a mother and baby unit. I've said I would be open to this but would like to at least get 6-8 weeks of breastfeeding in if possible. So the plan is to first introduce mirtazapine if my symptoms aren't too severe to give me some time breastfeeding before thinking about lithium

Thanks @SuperscientistI should have mentioned that I am currently on lithium and that has been the best at keeping my episodes at bay for 3 years. How ever I’m abit apprehensive about being off it now. Did you notice any side effects with quetiapine when you were taking it. I looked it up and honestly I’m a bit scared. However you have given me hope I would love to exclusively breastfeed for 6 months at least then see how it goes with building a stash so I can carry on. Thank you for taking the time to reply.

I've been on quetiapine for nearly 13 years and haven't had many side effects. I do find i can crave high fat foods and have to be mindful of what I eat but haven't gained much weight in that time. About half a stone after turning 30 and nearly half a stone after stopping breastfeeding neither of which are necessarily down to the quetiapine

I had more side effects with the lithium but my current consultant thinks I was probably slightly toxic. I don't know how far along you are but I had to stop lithium to conceive as it can cause heart defects if taken in the first trimester. I can be reintroduced later pregnancy although my Dr would only want me on half the dose I was on previously. I needed blood levels of 0.9 for it to be effective

@SuperscientistAh okay I need the lithium to be 6-6.5 to be effective but I can work with 4.0 too. But I’m a bit reassured that quentiapin has worked so well for you 13 years is amazing. I am currently weaning myself off lithium to hopefully start quentiapin in October just in time for my frozen embryo transfer. To be honest many people have been discouraging me about breastfeeding but I feel very strongly about it and I want to do my best by my baby.