Tegretol for epilepsy

I have a friend who is an epileptic and would like to breastfeed. She is seven months pregnant and is presently taking 1800 mg. of Tegretol each day. Her normal dosage when not pregnant is 1400 mg. She has spoken to four doctors: her epilepsy doctor, her OB/Gyn, a high-risk Ob/Gyn and a pediatrician and has received varying information in regard to taking this medication while nursing. Can you give me any specific information.

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Breastfeeding is not contraindicated for the mother with seizure disorders. Since Tegretol (carbamazepine) is currently being used during your friend's pregnancy, her baby is already receiving this medication. Breastfeeding actually provides a way to withdraw her baby slowly from the medication, helping to avoid any symptoms of withdrawal.

Tegretol is an anticonvulsant used in treating seizure disorders. It has been approved for use in breastfeeding mothers by the American Academy of Pediatrics Committee on Drugs. Concentration in breastmilk ranges from 1.3 to 3.6 milligrams per liter of milk, assuming a maternal dose of 200 to 800 mg. per day. Your friend is receiving almost twice this level of medication, so I would assume that the levels in her milk would be higher.

When your friend's baby is born, it is important that she be watched for extreme drowsiness. Her baby may be very sleepy during her first few days of life, so if she isn't nursing well, I would recommend that your friend express her milk with a hospital-grade electric breastpump for every feed that is missed (about every two to three hours.) Her milk can be fed to her baby, using a syringe or a cup, rather than a bottle, to avoid suck confusion.

It is important for your friend to share this information with her physicians, so they can work as a team to help assure an excellent outcome. Best wishes to you and your friend!

Warmly,
Debbi

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