After Childbirth: Parenting Concerns of Women with Epilepsy

Congratulations! You're a mother! You've successfully become pregnant and given birth to your baby. This is something many women take for granted, but when you have epilepsy, fertility and pregnancy pose unique challenges. Now that you've had your baby, you probably have a number of concerns and questions. And you may or may not have to make some lifestyle changes to keep your baby safe and healthy.

One question will arise almost immediately. Can you safely breastfeed your child? Just as you may have worried about the effect of your antiseizure medications on your developing baby, you might wonder if these medications could be transmitted in your breast milk.

Effects of Epilepsy Medicines

For most women, the answer is that breastfeeding is safe for your child. Small amounts of anti-seizure medications appear in breast milk. You may have notice that your baby is sleepy; that's because some anti-seizure medications may cause sleepiness. Talk to your doctor about alternating between breastfeeding and bottle-feeding formulas. Remember, your baby was exposed to the drug during your pregnancy. The amount of medication found in breast milk is less than the amount in your bloodstream during pregnancy.

"If a mother wants to breastfeed, we generally say she should go ahead and do so," says Mark Yerby, MD, MPH, associate clinical professor of neurology, public health and preventive medicine at Oregon Health Sciences University. He is also the founder of North Pacific Epilepsy Research.

If you are taking phenobarbital (Luminal) or primidone (Mysoline), you may notice that your baby is overly sleepy or irritable. If this becomes a problem, ask your doctor or the baby's pediatrician if you should supplement with a bottle.

Bringing Baby Home

Many women with epilepsy worry about what will happen if they should have a seizure while holding the baby. This is a normal, reasonable fear. The first thing to do is talk with your doctor about your concern. You and your doctor can work together to develop a plan to keep your baby safe.

Right after you come home from the hospital with your new baby, you may need some extra help in the house. Giving birth is exhausting and stressful, and involves a lot of hormonal changes. That can increase your risk of breakthrough seizures. So if someone offers to stay with you for a while to help with the baby and give you time to rest, you might want to take them up on it.

"The kinds of precautions you should take with your baby depend on what form your seizures take," says Jacqueline French, MD, professor of neurology at the University of Pennsylvania and co-director of the Epilepsy Center. For example, if you often have seizures where you lose awareness of your surroundings for a time, your baby could be in danger if you are the only adult there. You may want to arrange for another person to help you out until your child is a bit older. If your seizures are very well controlled, you should still take precautions to protect your baby, but you may not need someone else with you as often or for as long.