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Old 12-20-2015
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Default This Q killing me about antiepileptic drug

I've looked everywhere and couldn't find perfect answer
mother who has epilepsy controlled by phenobarbitol but she is breast feeding her baby what to do ?
Stop med or continues or anything else
With resource please. ...
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Old 12-20-2015
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Breastfeeding a newborn baby has many advantages, including maternal transfer of antibodies, as well as promoting bonding between mother and child. In addition, for many women, breastfeeding is an integral and important part of the experience of motherhood. Given these considerations, the American Academy of Neurology and the American Academy of Pediatrics advise that women with epilepsy taking AEDs can breastfeed.[48] During breastfeeding the baby will, however, continue to be exposed to the AED in varying concentrations depending on the prescribed AED. If mothers receiving ethosuximide, phenobarbital or primidone choose to breastfeed, they should exercise caution and closely monitor the infant for sedation, lethargy and any significant clinical findings.[49] On the basis of small studies, including single-dose studies, case reports and short-term studies, phenytoin, carbamazepine and valproate are probably safe. These AEDs are all moderately to highly protein-bound, and are not transferred in high concentrations in breast milk. A small study of four infants indicates that lamotrigine might be transferred to the infant through breast milk in concentrations similar to those seen in the mother, as lamotrigine is extensively metabolized by glucuronidation, which is immature in infants.[50] Given these findings, infants who are breastfed by mothers receiving lamotrigine should be monitored.

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