Breast-feeding may help ease AED withdrawal.(Obstetrics)

BRECKENRIDGE, COLO. -- A strong case can be made for encouraging a few weeks or months of breast-feeding by epileptic women who continued their seizure medication throughout pregnancy, Jose E. Cavazos, M.D., said at a conference on epilepsy syndromes sponsored by the University of Texas at San Antonio.

In addition to all the usual benefits of breast-feeding, this practice greatly reduces the likelihood of neonatal antiepileptic drug (AED) withdrawal syndrome, said Dr. Cavazos, a neurologist at the university's South Texas Comprehensive Epilepsy Center.

Transplacental passage of AEDs occurs readily. Studies have shown maternal serum and umbilical cord blood concentrations of AEDs are generally similar. After being exposed to therapeutic AED concentrations throughout fetal life, a baby who experiences abrupt postpartum discontinuation often develops a withdrawal syndrome marked by increased irritability. This can be avoided by taking advantage of the fact that most AEDs enter breast milk in concentrations similar to those found in maternal serum.

"Many women have an irrational attitude of 'I don't want to give my baby this medicine.' I tell such a patient that for the last 9 months, her baby has been exposed to an AED. I suggest breast-feeding for the first several weeks, then weaning from the breast and, in that way, gradually weaning the baby off the medication. When it's presented in that light, it's ...