From the Research
Olanzapine and quetiapine are generally considered the safest antipsychotics for breastfeeding mothers, as they have relatively low transfer into breast milk, resulting in minimal infant exposure. These medications have been studied extensively, and their pharmacokinetic properties, including high protein binding and limited milk penetration, support their use during breastfeeding 1. When prescribing, olanzapine is usually started at 5-10 mg daily, while quetiapine begins at 25-50 mg twice daily, with doses adjusted based on symptom response. Mothers should take these medications immediately after breastfeeding and before the infant's longest sleep period to minimize exposure. Regular monitoring of the infant for excessive sedation, feeding difficulties, or developmental concerns is essential.
- Key considerations for breastfeeding mothers taking antipsychotics include:
- The medication's transfer into breast milk and potential effects on the infant
- The mother's mental health and the need for effective treatment
- The importance of regular monitoring of the infant for any adverse effects
- The need for individualized treatment plans and close medical supervision Other antipsychotics like risperidone and aripiprazole may be considered but have less safety data, while clozapine should be avoided due to potential serious adverse effects in infants 2. The most recent and highest quality study supports the use of olanzapine and quetiapine as first-line treatment options for breastfeeding mothers 1.