I want to tell my story and strongly encourage any woman who is:

a)On monotherapy with seizures well controlled

b)Thinking about motherhood

c)Thinking about nursing

To have your baby, and breastfeed it.

I am 35 years old, and have a 3-month-old son. When I started thinking about getting pregnant, I was told that I would be a high-risk pregnancy if we even got pregnant- because of my age, and that the Lamictal might prevent me from having an entirely healthy baby. I found precious little information about the effects of Lamictal on pregnancy or a newborn. I wanted to share my story in case you are thinking about it too.

I took Lamictal through my entire pregnancy beginning with 200 mg/day and increasing to 300-mg/ day as my weight increased through the pregnancy.

I started taking prenatal vitamins prescribed by my ob-gyn, and extra Folic acid in my first 2 trimesters on the advice of my OB gyn. Third trimester I stopped with the Folic but continued with the prenatal vitamins and am still on them.

In the last 2 weeks of my pregnancy, I took vitamin K supplements (your doc has to prescribe it- who knew?) but other seizure medications have been known to cause internal bleeding in newborns that is usually not discovered until they are a couple of days old- whereas the vitamin K will prevent this problem from happening. My OB-gyn had never heard this and I had to fight a little to get the prescription, but she didn’t see any reason why it would do me or baby harm, so she wrote it.

I had every test done except an amniocentesis- and all of them turned out fine.

Setbacks:

I bled. Starting my second trimester, when almost all danger of a miscarriage is over…I woke up one night, felt a little snap inside me, and started bleeding A LOT. It was alarming- I thought for sure I was miscarrying, but it didn’t hurt. I had heard that miscarriages were incredibly painful and when I didn’t feel that pain, after 2 days (this happened on a Friday night and couldn’t see the doc till Monday) I started to wonder if maybe this was related to the Lamictal. I still don’t know- but I know other seizure meds are known to cause bleeding during pregnancy, so maybe Lamictal is the same.

Didn’t know for sure if the baby was ok until we got an ultrasound- the first thing we saw was his heartbeat and my husband and I both started crying…we are two pretty stoic people, but it was just such a relief. The ultrasound also showed a dark sac-like area on the outside of the placenta- not like it was detaching from the uterus, but just something my doc, and the ultrasound doctor had never seen.

Anyway- I bled for a good 6 weeks. My doctor put me on bed rest, and monitored that dark area with ultrasounds every 3 weeks. As the bleeding subsided, the dark area shrank and eventually went away. I don’t know what it was, neither does my doc, but the baby was fine. Oh, and bed rest sounds like it would be fun, but it isn’t. Nobody brings you bonbons or does your toenails for you…just some misconceptions I had. : )

Also, I had 2 seizures- one at 5 months and one at 7 months. My neurologist said the baby probably felt the pressure of my muscles contracting, but it wouldn’t have any detrimental effects unless I stopped breathing, which I didn’t, and never have during any seizure that I know of.

Of course my OB ordered an ultrasound both times and the baby was fine, as far as you can tell with an ultrasound.

Delivery was by c-section because my labor wasn’t progressing after 9 hours- but this has more to do with how I am shaped than anything related to epilepsy.

The baby was beautiful – his skin was unmarked, no physical problems at all. Apgars were 8 in the first minute of birth, then 5 minutes later were a 9- he didn’t get a 10 because his fingers were still not completely pink, which is very common. Most of his developmental markers are ahead based on the “what to expect the first year” book.

Today, he is smart and alert and I am reasonably sure he is not autistic- because he loves to interact with people, loves to look at faces, makes good eye contact, and loves to be tickled. Although you can’t diagnose Autism for sure until they are 2 or older, the early signals of Autism just aren’t there.

I had his Lamictal levels checked in the hospital. Again, I had to fight with his pediatrician a little to get it done, but in the end, his levels were less than 1 microgram per ML of blood.

I made the decision to stay on the medication and nurse him. Nursing is going well- I have heard tell that Lamictal can dry up your milk supply but I haven’t found that to be true- to the contrary, I have more than enough and could actually donate to a milk bank, but hesitate to do so because of the Lamictal in my milk.

I had his Lamictal levels checked again at 12 weeks of age and they had increased to 1.2 micrograms per ML of blood. This is well below therapeutic levels, but from this increase I would guess that infants don’t metabolize Lamictal. Again- no one seems to know for sure.

He is definitely getting Lamictal in the milk, but his pediatrician doesn’t seem to be concerned with this because the levels are so small. I am getting a second opinion tomorrow, so I can update and let you know what I find out.

Anyway- sorry to write a book, but if you are at all thinking about having a child and are hesitating because of your epilepsy- I would encourage you wholeheartedly to do it.