Lithium carbonate and breast-feeding.

Lithium carbonate and breast-feedingLithium carbonate taken during pregnancy has been associated with neonatal hypotonial and congenital heart disease.2There is little information on lithium concentrations in human breast milk or in the serum of breast-fed infants.We have studied such a case. Case reportA 36-year-old woman, gravida 1, para 0+1, had been taking lithium car- bonate for manic depressive psychosis for seven years when pregnancy was confirmed at eight weeks.The pregnancy was allowed to continue.Initially maintained at 800 mg daily, the dose was reduced twice during pregnancy to maintain therapeutic serum levels (see figure).Her mood was more stable than at any previous time, and she needed no other medication apart from routine haematinics.At 38 weeks she went into spontaneous labour last- ing 12 hours and received protective forceps for suspected prematurity.