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Breastfeeding recommendations for women taking anti-seizure medications

  • Author Footnotes
    1 Neurology at Boston University School of Medicine, 72 E Albany Street, Boston, MA 02118, United States.
    Abrar O. Al-Faraj
    Footnotes
    1 Neurology at Boston University School of Medicine, 72 E Albany Street, Boston, MA 02118, United States.
    Affiliations
    Boston Medical Center, Boston University School of Medicine, United States
    Search for articles by this author
  • Author Footnotes
    2 ORCID ID = 0000-0001-5041-1383.
    Trudy D. Pang
    Correspondence
    Corresponding author at: Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, West Campus, Boston, MA 02215-3908, United States.
    Footnotes
    2 ORCID ID = 0000-0001-5041-1383.
    Affiliations
    Beth Israel Deaconess Medical Center, Harvard Medical School, United States
    Search for articles by this author
  • Author Footnotes
    1 Neurology at Boston University School of Medicine, 72 E Albany Street, Boston, MA 02118, United States.
    2 ORCID ID = 0000-0001-5041-1383.

      Highlights

      • Breastfeeding is safe and should be encouraged for most women taking most commonly prescribed anti-seizure medications.
      • Infants breastfed by mothers taking anti-seizure medications do not experience long-term neurodevelopmental side effects and have been shown to have slightly better developmental outcomes compared to non-breastfed infants.
      • Rates of breastfeeding in women with epilepsy remain lower than the general population, which are likely due to factors related to clinicians and unique challenges in women with epilepsy, and highlights the need for effective breastfeeding counseling and additional supportive measures to improve breastfeeding practices in women with epilepsy.

      Abstract

      The literature regarding breastfeeding and effects of anti-seizure medication (ASM) exposure on the breastfed infant has been evolving rapidly over the last decade as new studies advance our understanding of the extent of medication exposure via breastfeeding and the long-term developmental outcomes of breastfed infants. Currently, strong evidence supports the safety of breastfeeding for women with epilepsy (WWE) taking most prescribed ASMs. In this review, we present a comprehensive overview of the data regarding ASM exposure in breastfed infants and neurodevelopmental outcomes in breastfed infants of mothers taking various ASMs. In addition, we present current breastfeeding recommendations and the reported adverse effects of various ASMs to facilitate decision making in the clinical care of WWE.

      Keywords

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