Table 5.

Highlights regarding AED use during breastfeeding.

• None of these drugs are contraindicated during breastfeeding, although the reported RID of LTG and PB can far exceed the threshold that is assumed to be safe (10%).

• A few well-designed studies showed no association between AED exposure via breastfeeding and adverse cognitive outcomes in children. Of interest, favourable trends on the outcomes were reported. More studies are needed in this area, particularly focusing on new AEDs such as levetiracetam.

• Sedation appears to be more common with PB or combinations in which PB is also used.

• Withdrawal symptoms after abrupt discontinuation of breastfeeding were experienced for PB and LEV (PB was a concomitant drug among the cases).

• A repeating pattern of liver dysfunction was detected for CBZ. The clinician may consider monitoring liver enzymes of infants exposed to CBZ via breast milk.

• LTG was reported with a wider spectrum of serious adverse events compared to other drugs.

• Rare but serious adverse events have been reported, and therefore, the clinician and the mother should be vigilant.

• Infants whose mothers use these drugs as mono or polytherapy during breastfeeding should be closely monitored with regard to drowsiness, sedation, irritability, feeding difficulties and age-appropriate growth.