Epilepsy in pregnancy breastfeeding management

Evidence-based neurology checklist on epilepsy in pregnancy breastfeeding management: Principles of breastfeeding on AEDs Women on AEDs are encouraged to breastfeed The mother should breastfeed in the middle of a large bed or in a chair AED levels in breastmilk are usually not high enough to cause…

Principles of breastfeeding on AEDs

  • Women on AEDs are encouraged to breastfeed
  • The mother should breastfeed in the middle of a large bed or in a chair
  • AED levels in breastmilk are usually not high enough to cause side effects
  • Breastfeeding does not adversely affect the child’s cognitive function

Safe AEDs with lactation

AEDs with uncertain safety evidence in lactation

AEDs to avoid with lactation

AED side effects: lethargy and irritability: causes

AEDs side effects: sedation: cause

References

  1. Stephen LJ, Harden C, Tomson T, Brodie MJ. Management of epilepsy in women. Lancet Neurol 2019; 18:481-491. 
  2. Nucera B, Brigo F, Trinka E, Kalss G. Treatment and care of women with epilepsy before, during, and after pregnancy: a practical guide. Ther Adv Neurol Disord 2022; 15:17562864221101687. 
  3. Davanzo R, Dal Bo S, Bua J, Copertino M, Zanelli E, Matarazzo L. Antiepileptic drugs and breastfeeding. Ital J Pediatr 2013; 39:50. 
  4. Meador KJ, Baker GA, Browning N, et al; NEAD Study Group. Effects of breastfeeding in children of women taking antiepileptic drugs. Neurology 2010; 75:1954-1960.
  5. Meador KJ, Baker GA, Browning N, et al; Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) Study Group. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years. JAMA Pediatr 2014; 168:729-736.

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