How to Manage Epilepsy and Breastfeeding

August 29, 2020
Breastfeeding and epilepsy are a combination that often raises doubts in new mothers with this disease. Continue reading as we're about to give you some recommendations to do so safely while being on medication.

Generally, breastfeeding and epilepsy are recommended for all newborns of mothers with this condition. In fact, the use of antiepileptic drugs doesn’t lead to side effects in a baby.

This is a very frequent question among epileptic mothers who want to breastfeed their babies, and its something to consider in such cases. The care of a child also depends on proper feeding as the main factor in their growth.

Today’s article contains some recommendations to keep in mind in order to minimize any possible unwanted effects. Let’s start by stating that epilepsy and breastfeeding are compatible.

Some definitions about epilepsy

Epilepsy is defined as a disorder in which a person has seizures due to an underlying chronic process in the brain. Furthermore, this process causes repeated discharges of neuronal impulses, synchronously.

Similarly, a seizure is a sudden episode produced by abnormal and excessive discharges or synchronous brain neuronal activity. This will produce an imbalance between arousal and inhibition in the brain.

We must clarify that the presence of one or more seizures, the cause of which is correctable and avoidable, isn’t synonymous with epilepsy. As we mentioned previously, there’s no correction for an alteration at the brain level when it comes to epilepsy.

There are various types of epilepsy and each one has a particular treatment and prognosis. The use of antiepileptic drugs is the most widespread approach modality.

Electric activity in the brain.
The synchronous and excessive discharge of many neurons at the same time leads to an epileptic seizure.

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Treatments for epilepsy

The treatment of a patient suffering from epilepsy is based on antiepileptic drugs. As you may anticipate, it’s the most frequently used measure in the approach to this pathology.

The ideal scenario is to completely prevent the appearance of seizures without side effects or at least minimize them. Preferably, doctors prescribe a single drug. This is referred to as the lowest effective dose of monotherapy.

Thus, physicians always start by administering a single antiepileptic drug, and then they’ll increase the dose if necessary. Some patients are more resistant to therapy and will have to use more than one drug.

In general, finding the right treatment is an adjustment process that can take a long time before getting the most appropriate one for a person. Doctors measure and perform dosing studies by sampling a patient’s blood in order to make adjustments.

Breastfeeding and epilepsy

Breastfeeding and epilepsy are finally compatible. It’s important for these mothers to carry out closer controls during pregnancy and the postpartum stage.

During pregnancy, they must pay more attention to measurements of antiepileptic drugs in the blood. This is because pregnancy can decrease the medication that’s distributed in the body. Thus, seizures would be an added risk to a pregnant woman. For these reasons, it may be necessary to increase the dosage during these stages.

Once a woman gives birth she must take certain things into account to change the treatment and to care for her baby during the lactation stage:

  • There should be an adjustment in the dose of antiepileptic medicine, doctors usually decrease it
  • Seizures may appear as a consequence of poor sleeping; doctors advise a mother to sleep enough in order to avoid this trigger factor
  • Women should avoid co-sleeping with a baby and never bathe them on their own

As we said above, there are no contraindications for breastfeeding if you’re epileptic. On the contrary, doctors advise to do so whenever possible for at least six months and then continue it for two more years as a complement to a baby’s diet.

Medication for epilepsy and breastfeeding

A woman with epilepsia breastfeeding.
Some medications are compatible with breastfeeding, and some aren’t. Medical advice is a must in this regard.

There’s a long list of different antiepileptic drugs a person can use on a regular basis and they integrate into a woman’s breast milk in varying amounts.

Despite this, there are no recorded unwanted effects in newborns whose mothers are under antiepileptic drug treatment. Some of them don’t significantly penetrate breast milk and others do.

The neurologist’s choice in regard to the antiepileptic medication they prescribe will take into account these types of differences. In addition, a mother mustn’t skip them, even if they have to divide the daily dose or allow a few hours after taking the medicine to feed the baby.

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Is medication safe for the baby?

A newborn may be drowsy and have difficulty eating or be irritable if the medication goes into their mother’s breast milk. For this reason, she must strictly control the dosage, based on her blood levels.

In conclusion, let’s highlight the importance of close monitoring by a neurologist during pregnancy and lactation in order to take good care of the health of the newborn and their mother. Only a doctor can indicate how to use medication and when to suspend the treatment, if ever.

  • Kasper y col., Principios de medicina interna de Harrison, ed. Mac Graw Hill. Ed. 19.
  • J.M. Mercadé Cerdá y col., Guía oficial de la Sociedad Española de Neurología de práctica clínica en epilepsia, Vol. 31. Núm. 2. páginas 121-129 (Marzo 2016).
  • Llerda y col., Guía oficial de la Sociedad Española de Neurología de práctica clínica en epilepsia. Epilepsia en situaciones especiales: comorbilidades, mujer y anciano, Neurología Volúmen 30,  Octubre 2015, Pág. 510-517.