Childbirth & later: Can I breastfeed if I have Epilepsy?

This is the final article in the complete guide to Pregnancy in Epilepsy.

At the end of pregnancy, most women have normal childbirth. Occasional women may need a caesearean section.

Most seizure medications are safe while breastfeeding. However, some seizure medications are less safe for the baby.

Hence talking to a pediatrician before breastfeeding is essential.

If I have Epilepsy, will I have a complicated childbirth?

Usually women with epilepsy do not have complicated childbirths.

For example:
Researchers in Norway studied 400 thousand deliveries. They compared childbirths in women with and without epilepsy. There were only minor differences in childbirth between these two groups.

Your gynaecologist should be comfortable in handling patients with Epilepsy.

baby, birth, healthy baby
Your gyanecologist should be comfortable handling women with epilepsy.

In less experienced set-ups, having a cesarean section may be more likely. Per se, this is not a bad thing. An elective cesarean section may ensure good mother and child health.

Can I breastfeed if I have Epilepsy?

Epilepsy itself is not a concern for breast-feeding.

However, some medications are secreted in your milk. Your child may develop side-effects with these medications.

breast
The breasts have a rich supply of blood. Some medications can travel from blood to your milk.

Which seizure medications are safe while breastfeeding?

Most medications can be given with adequate precutions. But in terms of seizure medications safe while breastfeeding, there are some that are less safe.

You should discuss this with a pediatrician. Talk about the safety of seizure medications while breastfeeding. Discuss in detail about the pros/cons of breastfeeding.

Look at the table below to find seizure medications safe for breastfeeding.

This research is not complete. The question marks below indicate that we don’t know these things precisely.

Least safe?Less safe?Possibly safe?
Clonazepam and other sedating medications

Zonisamide

Ethosuximide

Phenytoin

Oxcarbazepine

Lamotrigine

Zonisamide

Topiramate

Pregabalin

Gabapentin

Vigabatrin

Phenobarbital/Primidone

Carbamazepine

Valproate

Levetiracetam

References:

  1. Use of antiepileptic drugs during breastfeeding : What do we tell the mother? – Crettenand et al 2018
  2. Antiepileptic drugs and breast feeding – Davanzo et al 2013

No matter which seizure medication you are taking – Check with your pediatrician before breast-feeding.

Summary:

  1. Most women with epilepsy have uncomplicated childbirths.
  2. Some seizures medications are more safe while breastfeeding
  3. Make sure you check with your pediatrician before breast-feeding.
  4. Be sure to read the “Safe Pregnancy in Epilepsy Checklist”.

 

Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar

Dr. Siddharth Kharkar

Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.

Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.

He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

Call 022-4897-1800

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