Mothers on antiepileptic medication can safely breastfeed

Breastfeeding is associated with benefits for children and their mothers. However, when mothers take medications there is a potential for adverse side effects in the infant.

In a recently published study in JAMA Neurology, a University of Minnesota-led research team looked at antiepileptic drug (AED) exposure in infants who were breastfed by mothers with epilepsy.

For mothers with epilepsy, there is no consensus within the medical community on if breastfeeding while taking antiepileptic drugs could have adverse side effects on their children. While previous studies examined breast milk concentrations of antiepileptic drugs, it did not account for the amount of antiepileptic drugs metabolized by the child. U of M researchers found that the antiepileptic drug concentrations in blood samples of infants who were breastfed were substantially lower than maternal blood concentrations.

They accomplished this by analyzing samples from breastfed infants and their mothers between five to 20 weeks after birth. The amount of AED concentrations was measured from blood samples taken from both mother and child. These mothers and infants were enrolled in the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study.

"We measured the drug concentrations directly in infants that reflected overall drug exposure to the infant through breast milk," said Angela Birnbaum, a professor in the College of Pharmacy. "Our study supports breastfeeding for mothers with epilepsy who are taking antiseizure medications. This means that primary care providers can have more informed conversations with recent and expecting mothers about the possibilities of breastfeeding their child."