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Vol. 26 - Num. 103

Clinical Reviews

Newborn with lithium levels in toxic range. Should we stop breastfeeding?

Roberto Ortiz Movillaa, M.ª del Carmen Muñoz Labiánb, Miguel Sánchez Mateosb, Miguel Ángel Marín Gabriela

aUnidad de Neonatología. Hospital Universitario Puerta de Hierro Majadahonda. Facultad de Medicina. Departamento de Pediatría. Universidad Autónoma de Madrid. Madrid. España.
bUnidad de Neonatología. Hospital Universitario Puerta de Hierro . Majadahonda. Madrid. España.

Correspondence: R Ortiz. E-mail: roberto.ortiz@salud.madrid.org

Reference of this article: Ortiz Movilla R, Muñoz Labián MC, Sánchez Mateos M, Marín Gabriel MA. Newborn with lithium levels in toxic range. Should we stop breastfeeding? . Rev Pediatr Aten Primaria. 2024;26:285-90. https://doi.org/10.60147/24988d9a

Published in Internet: 27-09-2024 - Visits: 1285

Abstract

Lithium is a common part of the treatment for bipolar disorder. It is excreted through breast milk, and traditionally, mothers undergoing this treatment were advised to discontinue breastfeeding due to the potential serious adverse effects of this medication on the infant. More recently, it has been demonstrated that plasma lithium levels in exposed children are generally low and well tolerated, so, in selected cases, breastfeeding can be maintained, and close clinical and analytical monitoring of the child can be conducted, including measurement of thyroid and renal function, and serial lithium levels. We present a clinical case of a full-term newborn, born to a mother with bipolar disorder receiving lithium treatment, exclusively breastfed on demand, who in the second week of life showed toxic levels of lithium in plasma with no symptoms. Careful investigation of the case revealed that the elevated lithium levels were falsely elevated due to incorrect collection of the blood sample in a container containing lithium-heparin as an anticoagulant. The circumstances of the case will be reviewed as well as current recommendations on lithium intake by mothers and breastfeeding of their children.

Keywords

Breastfeeding Lithium Newborn

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