Pregnant women with epilepsy often ask whether they will be able to breastfeed. Many have been given conflicting advice when there were scant data to answer the question. Often that advice comes from the obstetrician or pediatrician, not the neurologist. There is concern about sedation from drugs such as phenobarbital, yet there is clearly a benefit for infants to be breastfed in terms of nutrition and immune system enhancement. Larger concerns include the long-term effect of postnatal exposure on brain health as the infant grows. Previous guidelines have an expert opinion that favors breastfeeding, when addressed, but these guidelines also document the lack of specific data on the safety of long-term breastfeeding.1- 4 The argument in favor of breastfeeding largely derives from the benefits seen in epidemiologic studies that apply to the general population.
Paul C. Van Ness. Breastfeeding in Women With Epilepsy. JAMA Neurol. 2013;70(11):1357–1358. doi:10.1001/jamaneurol.2013.4348