Is Breastfeeding Safe for Infants of Women With Epilepsy on Antiseizure Medication?

Article published by Neurology Advisor

Antiseizure medications (ASMs) can be detected in breast milk of women with epilepsy and plasma/serum of infants who have consumed breast milk, according to study findings published in Seizure: Journal of Epilepsy.

Global health organizations recommend exclusively breastfeeding infants for at least 6 months. Deciding whether to discontinue ASMs is a serious concern for half of women with epilepsy who are of childbearing age. Many studies have assessed concentrations of ASMs in breast milk of lactating women with epilepsy, but this is the first systematic review of those concentrations.

Researchers searched several databases and Google Scholar to identify English-language observational studies that reported levels of ASMs in lactating women with epilepsy. They found 15 studies (9 cross-sectional 4 prospective cohort 2 case series studies) with generally acceptable quality. Ten studies were published since 2000; 10 studies originated from Germany or Sweden; and each study involved fewer than 50 women with epilepsy.

“The studies included in this review have shown that many ASMs were excreted into breastmilk in high concentrations,” the researchers said. “However, the majority of these ASMs did not produce significant adverse effects that warrant discontinuation of breastfeeding.”

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