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Lamictal and pregnancy

Mon, 02/07/2005 - 20:43

Hi everybody

I have juvenile myoclonic epilepsy. I am currently 32 weeks pregnant and take 300mg of lamictal daily and have remained seizure free and well so far. 

I am concerned about the long term side effects of lamictal on my baby if I breast feed. I have recently read a paper "Concerns regarding lamotrigine and breast feeding" by Liporace et al which makes me concerned about the babys ability to metabolise the drug. I now think that I do not wish to breast feed my baby, but I am wondering if my baby goes through withdrawel from lamictal in the early stages of life will he suffer long term side effects from this. I know that breast feeding and especially colostrum has long term benefits but i am cautious due to the lack of information about what process the baby will use to metabolise it and how the build up of the drug in his system might affect his growth and development.

Has anyone else information or experience of bottle feeding or breast feeding a baby after taking lamictal through the pregnancy.

Would be gretaful for any input on how they are and if you think they went through withdrawal or any other side effects.

Thanks

Bugsbunny

Comments

RE: RE: Lamictal and pregnancy

Submitted by happycat2 on Mon, 2005-07-11 - 12:53

Hi.

I have read through your posts ,and you already know from Amy  that  both your neurologist and your gynecologist/obstetrician need to be involved in reviewing your antiepileptic drug .Certainly  to  discuss any potential medication changes prior to the beginning of a pregnancy for your safety and the child's. Different drugs control certain types of epilepsy best- and are less effective for other types.There seems to be such a diversity globally on their effects I have read on another site worlds apart from this one. It's  important that  you can be treated with the lowest dose of the most effective drug. GlaxoSmithKline are saying  new research shows an interaction between lamotrigine and oral contraceptives which may result in the reduced effectiveness of the contraceptives. 

http://www.epilepsy.org.uk/news/index.html

The importance of working with your health care team to make the best decisions about medications during pregnancy cannot be stressed enough(Shawna Cutting has researched this.) her article is on this site, along with other information on aed's and pregnancy that covers your post quite thoroughly.

Amy got it right in her reply...You may be able to breast-feed your baby even if you are taking antiseizure medication,as most of these medications pass into the breast milk in very small amounts and are not likely to harm your baby. Before beginning breast-feeding however, review your medications seems sensible advice. I  started out on dilantin and took it for several years,then I took topamax and finally tegretol which works great for me,and breast fed all my children.

Thanks Amy for posting.

Cat. 

 

Hi.

I have read through your posts ,and you already know from Amy  that  both your neurologist and your gynecologist/obstetrician need to be involved in reviewing your antiepileptic drug .Certainly  to  discuss any potential medication changes prior to the beginning of a pregnancy for your safety and the child's. Different drugs control certain types of epilepsy best- and are less effective for other types.There seems to be such a diversity globally on their effects I have read on another site worlds apart from this one. It's  important that  you can be treated with the lowest dose of the most effective drug. GlaxoSmithKline are saying  new research shows an interaction between lamotrigine and oral contraceptives which may result in the reduced effectiveness of the contraceptives. 

http://www.epilepsy.org.uk/news/index.html

The importance of working with your health care team to make the best decisions about medications during pregnancy cannot be stressed enough(Shawna Cutting has researched this.) her article is on this site, along with other information on aed's and pregnancy that covers your post quite thoroughly.

Amy got it right in her reply...You may be able to breast-feed your baby even if you are taking antiseizure medication,as most of these medications pass into the breast milk in very small amounts and are not likely to harm your baby. Before beginning breast-feeding however, review your medications seems sensible advice. I  started out on dilantin and took it for several years,then I took topamax and finally tegretol which works great for me,and breast fed all my children.

Thanks Amy for posting.

Cat. 

 

RE: RE: Lamictal and pregnancy

Submitted by bugsbunny on Sat, 2005-07-16 - 15:26
Dear stanley2b,I found the advice I got through discussion on this forum last year very useful. I have a healthy son who has thrived on formula. We alkl know that breast feeding is best but in some cases it may not be. It was your choice to breast feed and I am glad it went well. I made the best decision I could based on the knowledge I had from reading the published scientific papers. I did as much research as I could and found that none of the scientific studies on breast feeding and lamictal could be relied apon because the sample population was so small (in some cases as few as 8 babies). I discussed this at length with many coleagues who are chemists and biochemists. All of them said that the mechanism by which adults break down lamictal is not present in babies. The questions that remain then are: Do the babies metalbolise lamictal at all, if they do how is it done and also what pathways and what by-products are produced? There is nothing known about how babies break lamictal down, where it goes and what way it is stored in their bodies. It was this information that made me choose not to breast feed, it is each mothers personal decision and we can only do what we think is best on the information we have at the time.I am glad that you and your family are well. My little one is growing by the minute (10 months old) and is healthy and a bundle of joy, all of which I thank god for.I did and do find this forum useful, it is excellent to hear from others in similar circumstances.BB

RE: RE: RE: Lamictal and pregnancy

Submitted by gonenative99 on Sun, 2005-07-24 - 14:59

Hello all- I am new to this community & I want to thank all of you who have posted your information and experiences with pregnancy and lamictal.  My first baby is due next week and I have found that the further my pregnancy goes, the more frightened I get at the "what ifs" that cross my mind at 3:00 am.  I feel so much comfort from the information you have shared and I have to note that out of all the postings I have read so far... not one person has said they have experienced birth defects or developmental delay in their children who were concieved, carried and/or breastfed on Lamictal. I hope I can write back in a few weeks and report a normal delivery and a healthy mama and child as well.

I have been taking 300 mg Lamictal the whole pregnancy, supplemented with the higher levels of folic acid in the first trimester and the 10 mg vitamin k these last few weeks.   I plan on breastfeeding my baby when he comes next week- I have done alot of research on breastfeeding as well- consulting 2 pediatricians, my neurologist, and 2 lactation consultants- who all encourage me to breastfeed, by the way.

  ****Most of the information I have found is the same as what you have already posted, buuuut- the lactation consultants had a book- of course I don't have the exact title, but it addressed medications in breastmilk.  Apparently we metabolize drugs in our breast milk differently than we do in our bloodstreams.  Lamictal was there- listed under Lamotrigine- It was a scientific text, and I'm not sure I understood it fully, but what I got from it (and the lactation consultants, who I will acknowledge are heavily biased for breastfeeding) was that its possible to take your medication and have your child not exposed to Lamictal in your breastmilk AT ALL- because it will metabolize out of your breastmilk anywhere from 1-4 hours after you take it!  So saying- you can take your medication- do a "pump and dump" to get rid of the lamictal-tinged milk, then the next feeding you are offering your child Lamictal free nutrition. ****

I will follow up and try to find the name of the textbook so you all can check- and I also plan on having the baby tested for Lamictal levels and if I find them increasing then I will of course switch to the bottle- but its worth a shot. Maybe we can have the best of both worlds?

Hello all- I am new to this community & I want to thank all of you who have posted your information and experiences with pregnancy and lamictal.  My first baby is due next week and I have found that the further my pregnancy goes, the more frightened I get at the "what ifs" that cross my mind at 3:00 am.  I feel so much comfort from the information you have shared and I have to note that out of all the postings I have read so far... not one person has said they have experienced birth defects or developmental delay in their children who were concieved, carried and/or breastfed on Lamictal. I hope I can write back in a few weeks and report a normal delivery and a healthy mama and child as well.

I have been taking 300 mg Lamictal the whole pregnancy, supplemented with the higher levels of folic acid in the first trimester and the 10 mg vitamin k these last few weeks.   I plan on breastfeeding my baby when he comes next week- I have done alot of research on breastfeeding as well- consulting 2 pediatricians, my neurologist, and 2 lactation consultants- who all encourage me to breastfeed, by the way.

  ****Most of the information I have found is the same as what you have already posted, buuuut- the lactation consultants had a book- of course I don't have the exact title, but it addressed medications in breastmilk.  Apparently we metabolize drugs in our breast milk differently than we do in our bloodstreams.  Lamictal was there- listed under Lamotrigine- It was a scientific text, and I'm not sure I understood it fully, but what I got from it (and the lactation consultants, who I will acknowledge are heavily biased for breastfeeding) was that its possible to take your medication and have your child not exposed to Lamictal in your breastmilk AT ALL- because it will metabolize out of your breastmilk anywhere from 1-4 hours after you take it!  So saying- you can take your medication- do a "pump and dump" to get rid of the lamictal-tinged milk, then the next feeding you are offering your child Lamictal free nutrition. ****

I will follow up and try to find the name of the textbook so you all can check- and I also plan on having the baby tested for Lamictal levels and if I find them increasing then I will of course switch to the bottle- but its worth a shot. Maybe we can have the best of both worlds?

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