Epilepsy and breastfeeding represent a combination that raises doubts in mothers with the disease. We are going to unravel in this article what are the recommendations for breastfeeding, despite being medicated.

Breastfeeding, in general, is recommended for all newborns of mothers with epilepsy. Usually, the use of antiepileptic drugs does not cause side effects in the baby who takes breast milk.

This is a very frequent question among epileptic mothers when it comes to breastfeeding, and that is why it represents an issue that must always be considered in these cases. The care of the child also depends on the correct feeding as the axis of growth.

We will see some recommendations to take into account to minimize any possible unwanted effects. We start from the affirmation 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. This process causes repeated discharges of neuronal impulses, synchronously.

On the other hand, the seizure or seizure is a sudden episode produced by these abnormal and excessive discharges, or synchronous brain neuronal activity. This will produce an imbalance between arousal and inhibition of the brain.

We must clarify that the presence of one or more seizures, the cause of which is correctable or avoidable, is not synonymous with epilepsy. In epilepsy, as we mentioned previously, there is an alteration at the brain level that cannot be corrected.

There are different types of epilepsies, and each one has a particular treatment and prognosis. The use of antiepileptic drugs is the most widespread approach.

What is the treatment used in epilepsy?

The treatment of a patient suffering from epilepsy is based on the indication of antiepileptic drugs. As we anticipated, it is the measure that is most used in the approach to this pathology.

The ideal scenario is to achieve complete prevention of the appearance of seizures, without presenting side effects, or at least minimizing the appearance of them. Preferably a single drug will be used. This is called the lowest effective dose monotherapy.

Always start by administering a single antiepileptic drug, on which the dose will be increased, if necessary. In some cases that are more resistant to therapy, it will be necessary to use more than one drug.

In general, finding the right treatment is an adjustment process that can take a long time to reach your goal. To carry out these adjustments, measurement and dosing studies are performed on the patient’s blood.

Special aspects of epilepsy during breastfeeding

Today, epilepsy and breastfeeding are compatible. It is very important that these mothers carry out closer controls during pregnancy, as well as in the postpartum stage.

During pregnancy, more attention will be paid to measurements of antiepileptic drugs in the blood, since pregnancy can decrease the medicine that is distributed in the body. To this will be added a greater risk on the part of the pregnant woman of suffering seizures. For these reasons, it may be necessary to increase the dosage of the medication in these stages.

Once the delivery has passed, certain aspects will be taken into account that can change the treatment and care in the lactation stage:

  • Used dose of antiepileptic medicine: Usually a new dosage adjustment will be made. Almost always decreasing.
  • Possible appearance of seizures due to lack of good sleep: it is advisable to avoid lack of good sleep, as this is a triggering factor for seizures.
  • Newborn safety precautions: it is preferable to avoid co-sleeping, and carry out bathing activities for the newborn accompanied.

As we said, feeding through breastfeeding is not contraindicated. On the contrary, whenever possible it is advisable to keep it exclusively for six months, and then continue it during complementary feeding for two years.

Medicines for epilepsy and breastfeeding

There is a long list of different antiepileptic drugs used on a regular basis. These drugs pass into breast milk in varying amounts.

Despite this, with the vast majority of antiepileptic drugs used, no unwanted effects were seen in the newborn. Some of them do not penetrate into breast milk at significant levels, and others do.

The choice by the neurologist of the antiepileptic medication to be indicated will take into account these differences between drugs. In addition, it is important that the mother does not skip the doses, even if it is recommended to divide the daily dose or allow a few hours after taking the medicine to feed the baby.

Is it safe for the baby?

In cases where the passage of medications into breast milk is important, the newborn may be drowsy and have difficulty sucking or be irritable. It is for this reason that it is necessary to have a strict control of the dosage, based on the maternal blood levels.

In conclusion, we will highlight the importance of close monitoring by the neurologist during pregnancy and lactation, in order to take care of the health of the newborn and his mother. Only a doctor can define the use of drugs and their eventual suspension.


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