Breastfeed & Vimpat/Lamictal

babymayy00

Hello ladies if you take these medications are you breastfeeding? My neurologist strongly advised me not to do it. he said if it was his wife he wouldn't let her do it. He explained something about it only taking one particle. I didn't understand his reasoning. can you please help me with your experience, P.O.V etc... it crashed my heart knowing I wasn't going to be able to give my baby my nutrients. I am on my 2nd trimestre.

knottie_knottie1

My neurologist said Lamictal and Keppra were the recommended AEDs for women who are pregnant/breastfeeding, so I'm wondering if it's the Vimpat that your neurologist is concerned about (I've never been on Vimpat before, so don't know anything about it)

fertile-turtle

I suspect your neurologist’s concern is Vimpat, because there are only a few case studies of its use during pregnancy and breastfeeding. Lamictal is very well studied and is overwhelmingly safe during breastfeeding. They are encouraging, in that they didn’t report any problems, BUT they aren’t proper controlled studies, either, and I don’t think they're enough to make me, personally, comfortable if I were in your position. On the other hand, the fact that Vimpat is approved for 1 month old infants would be more comforting, because the dose through breast milk would be expected to be lower than the approved dose for infants.

That said, you have time to make the best decision for you and your baby, so you may want to ask a few questions to help you make an informed decision, and get second opinions from professionals with different perspectives and specialties, like your OB and pediatrician and maybe a neonatologist or pediatric pharmacist. If you get an “I don’t know,” you can ask who would, if there’s a specialty that they can consult with.

The things I’d want to know are:
-What is the specific concern? Is it something acute and reversible (that you could notice right away and stop without causing harm) or something chronic and irreversible?
-Is your dose high, medium, or low? What does that (likely) mean for the concentration in your breast milk? Is there anything about the pharmacokinetics that would make some feeding times safer than others?
-(For the pediatrician, specifically) If I try breastfeeding while taking these medications, is there anything I should watch for? Would you want to see my baby more often in the beginning to make sure everything is ok? Are there any additional tests or monitoring you’d want to do?
-Are there any conditions my baby could be born with that could make them more vulnerable (mostly I’m thinking of prematurity, but they may have other concerns)?

You have time to have several conversations with multiple professionals to get a better idea of the risks and benefits, and I’d definitely take advantage of that.

bustabucket

I take Lamictal, and have not been advised that it isn’t compatible with plans to breastfeed.