Lithium in breast milk transiently affects the renal electrolytic balance of infants

Irfan Ahmed, Muhammad Shehzad Khan, Victor Ma, Hina Magsi, Renardi Gunawan, Abdul Mojeed Olabisi Ilyas, Najeeb ur Rehman Lashari, Naveed Wassan, Santosh Paidi, Zulfiqar Ali, Alan W.L. Law, Yanpeng Zhang, William C. Cho, Martin Alda, Veerle Bergink, Ishan Barman*, Condon Lau*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: The use of lithium during breast-feeding has not been comprehensively investigated in humans due to concerns about lithium toxicity. Procedure: We analyzed lithium in the kidneys of nursed pups of lithium medicated mothers, using analytical spectroscopy in a novel rat model. The mothers were healthy rats administered lithium via gavage (1000 mg/day Li2CO3 per 50 kg body weight). Results: Lithium was detected in the breast milk, and in the blood of pups (0.08 mM), of lithium-exposed dams at post-natal day 18 (P18), during breast-feeding. No lithium was detected after breast-feeding, at P25 (4 days after cessation of nursing). The lithium pups blood had elevated urea nitrogen at P18 and reduced total T4 at P18 and P25, indicating a longer-term effect on the kidneys and the thyroid gland. Multivariate machine-learning analysis of spectroscopy data collected from the excised kidneys of pups showed elevated potassium in lithium-exposed animals both during- and after breast-feeding. The elevated renal potassium was associated with low nephrin expression in the kidneys measured immunohistochemically during breast-feeding. After lithium exposure is stopped, the filtration of lithium from the kidneys reverses these effects. Our study showed that breastfeeding during lithium use has an effect on the kidneys of the offspring in rats.

Original languageEnglish
JournalBipolar Disorders
DOIs
Publication statusE-pub ahead of print - 21 Nov 2022

Bibliographical note

Funding Information:
This research was supported by start‐up funding from the City University of Hong Kong (project numbers 7200414 and 9610338).

Funding information:
City University of Hong Kong, Grant/
Award Number: 7200414 and 9610338

Publisher Copyright:
© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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