In a message dated 7/14/02 3:41:07 AM Pacific Daylight Time,
[log in to unmask] writes:


> From:
> Subject: Re: Wellbutrin
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>
> I am in need of some LX help again!
> I am working with a mom of a Bfing 12 month old.  She is having problems
> with
> depression and was advised by her OB to start on Wellbutrin.  Also
> suggested
> stopping Bfing due to medication.
> I have searched the archives and come up with a few, all saying ok to bf.
> But nothing sounding very strong ok, just its not contraindicated.  Mom and
> Dr. are not very sure of this.  Anything more evidence-based?  Mom does not
> want to stop!
>      Thank you, Loretta Haycook, RN, IBCLC
>                       Neptune Beach. FL
>
>

According to the 1998 version of Hale, it states:  "Following a 100 mg dose
in a mother the milk:plasma ratio ranged from 2.51 to 8.58, clerly suggesting
a concentrating mechanism for this drug in human milk. However, t=plamsm
levels of bupropion (or its metabolites) in the infant wre undetectble,
indicating that accumulationin infant plasm apparently did not occur under
these conditions (infant was fed 7.5-9.5 hours after dosing).  The peak mik
bupropion level (.189 mg/L) occurred two hours after a 100mg dose.  This milk
level would provide a 0.019% of the maternal dose, a dose that is likely to
be clinically insignificant to a breastfed infant. "  The newer Hale may have
even more information.

0.189mg/L of wellbutrin is the approximate equivalent of feeding an infant  3
drops of wellbutrin in 420 gallons of milk.  (Based on the City of Garden
Grove Water report which breaks down parts per million and billions into
concrete measurements)  Consider how much milk this child is even taking in
per day especially at a year?
How incredibly dilute this must be and then it must be abpsorped and then
must be able to pass through the liver without being excreted in order to
move  into the blood stream.

Hale's reference is from Briggs-"Annal of Pharmacotherapy",  a text  OB's
commonly use.   Furthermore,  Wellbutrin is commonly given in pregnancy.

I personally have had a patient who took Wellbutron and nursed her child
without any problems.

Having said that,  why Wellbutronn?  Zoloft is considered the medication of
choice while breastfeeding, followed by Elavil or Paxil.
Christine Betzold NP IBCLC MSN
www.starfireinternational.net/breastfed

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