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Post Partum Issues in Women with Epilepsy
Post Partum
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Monitoring of maternal antiepileptic drug levels should continue postpartum. Levels gradually return to baseline by 12 weeks after delivery.
Mothers should be advised to avoid sleep deprivation.
Breast-feeding and child-care issues should be discussed.
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Breast Feeding
Many women with epilepsy can breast-feed.
The concentration of Anti Epileptic Drugs (AED) in breast milk is determined by its plasma level and its degree of protein binding.
Higher protein binding means that less is present in breast milk.
Both PHT & VA are highly protein-bound, so only low levels of drug are present in breast milk.
PHT is also very poorly absorbed from an infant's GI tract.
Breast-feeding is permissible with phenytoin or valproic acid.
CBZ & PB are present at higher levels in breast milk, and breast-feeding is less advisable with these agents.
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Serum Concentrations of AEDs in Breast Milk
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