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Lamictal and pregnancy

Hi everybodyI 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.ThanksBugsbunny

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 Congrats!  My daughter is 22 months old, and I was on 600mg by the time she was born.  (I just kept soaking the stuff up or something.  What has me grouchy is my new doc, who is an expert at Stanford, says that blood levels with Lamictal are more about compliance than seizure control. NICE.  Seems he wouldn't have cranked me up like that.  I was on 400 before my pregnancy, and 300 now.)  Anyhow, my daughter is brilliant, perfect, easy going, charming..... the drugs haven't seemed to affect her a bit.  I would LOVE to read that article about breastfeeding.... as you will see why:After her birth, at children's hospital, they did a couple of blood levels on her.  The strategy was since she had been soaking in it for 9 months the breastmilk wouldn't hurt her.  Thing is?  My breast milk never came in past 4 oz a day.  I was beyond fustrated and slaved away at every trick in the book for 4 weeks.  She got jaundice from starving w/in 2 days and dropped a ton of weight and so was on formula.  The only thing I would do next time is get an "SNS" this wee tube you put next to your nipple with formula.  Thus the baby still associates your breast with food, and it gives your breast time to get with the program. She was sleepy those first few days, but I am sure it wasn't withdrawl - it was hunger.  When ever we gave her a little formula to keep her going, she was COMPLETELY perky and alert.As she was getting no breast milk from me, she went from trace amounts of Lamictal at birth, to none by the time we left the hospital.As both my grandmother and my mom breastfeed I was blaming the drugs for my total lack of lactaion.  There is a drug they give to some women, but the major side effect of Reglan is.... seizures.  Even in the average population.  The first 6 weeks you will be totally sleep deprived and stressed - and at higher risk for a seizure right? yeah! no way was I going to take that stuff!We used Enfamil Lipil with Dr. Brown's bottles.good luck and get a maid service for the first 2 weeks!

Hi,Thanks so much for the info. My neurologist decided not to up my levels of lamictal, my blood levels have dropped about 40% so far, but he reckons I could weather the drop when its occurs gradually over time. I finished work when I reached 30 weeks to compensate by getting extra rest and no stress, so all is well so far thank goodness. Its really good to hear that your daughter is well. I think I will bottle feed, although the neurogist says the benefits most probably outweigh the risks, yet he doesn't know the risks of the baby getting lamictal long term. I am relieved to hear your baby did well on bottle feeding, I wonder if the fact that the baby gets plenty milk when bottle feeding helps them get over the withdrawel, you knwo how important a decent diet is for those of us with epilepsy. Anyhow you have put my mind at rest about bottle feeding, thanks. I don't know how to attach the document  to this mail, it is a pdf file. I could send it to an ordinary email address if you wish to give me one or if you know how I can attach the file here let me know. Anyhow the paper is Concerns regarding lamotrigine and breast feeding by liporace et al, 2004, epilepsy and behaviour journal.My brother got this copy for me, he works at a university, maybe you know someone who might be able to look it up or else if you wish to send me a email address, I can attach the pdf file to it and you can read it online.In summary the paper expresses concern about the recommendation that its ok to breastfeed with lamictal. Apparently the process (gluconiration or something like that) by which out bodies break down lamictal is not developed in children until they are much older. The research paper surveyed 10 babies that were breast fed and their blood  plasma lamictal levels increased every day, in other words the scientist suggested that the babies possible were not able to break down the lamictal, hence it was building up in their bodies and could potentially be toxic. You see then there is also the possibility that if they don't break it down by the same process as us and use some other mechanism it may be that they could produce a toxic by product from breaking down the drug. I am sorry if you are confused and I am not explaining this very well, it would be better if you read the paper.  My problem is I don't trust my neurologist telling me stuff with the words "most probably" in it, a friend who is a pharmacist suggested that breast feeding was a crazy idea especially when there was little or no data available on the long term effects of lamictal on the baby, in other words we know they get the potentially nasty stuff for 9 months but why lengthen the time exposed to the stuff by breast feeding.So you see really I am against the whole idea of breast feeding although my neuroligist and midwife is pro the idea. You have put my mind at ease about bottle feeding though and also you might be right in that my partner could do the night feeds etc.Let me know if you have any other thoughts.Thanks a mil. 

Hi,I'd just like to say congratulations on the pregnancy!!  I am just 33 weeks so at a very similar stage to you but I take Tegretol which has created some real dilemmas in taking it.  I hadn't had a fit (I have tonic-clonic but very infrequently) for 9 years so I felt, after having had a successful pregnancy with my son who is now 4, that I could safely cut down my dosage but on friday I had a full on seizure which has really shaken me up, of course mainly because of the risk to the baby.  I was rushed to hospital and put on a monitor - baby seems fine and I hope hasn't been adversely affected but it has really highlighted the difficulties with taking AEDs and pregnancy.  I chose to take a minimum dose because of Tegretol's notorious connections with birth defects but in the end I probably put the baby and myself at much more risk.  As far as breastfeeding goes, I think the benefits of having breast milk far outweigh the risks with the minute amount of Tegretol that gets through but with Lamictal I don't know.Continue to take it easy and as much as you can, avoid any triggers.  You are doing really well and not much longer now!!  What are you doing about labour, btw, are you concerned about having an attack during labour?  I wasn't until last week, when epilepsy so suddenly and cruelly re-entered my world, now I'm wondering if I might opt for a section instead.Rhiannon3 

Dunno trying not to worry about seizing during labour, the idea of a sections scares the living daylights out of me though

Hi Bugsbunny~~I am neither pregnant, nor have ever been or will due to my seizures and the many types I have.I have looked up in a Nursing drug book from this year and this is what it says about your thoughts and concerns.This drug has been shown to cause toxicity to the mother, and because of this, toxicity to the fetus.  Adequate studies of pregnant women are not available.Advisability of use if breat-feeding--presence of this drug is in the breast milk, and all people taking this drug while pregnant should be advised to bottle-feed at all times.That is what I could find on the subject matter.Most AEDs are not safe to take while pregnant for that reason, but people need them to function so they take them anyway.Nancy

Oh I hope this gets to you in time ladies. My son is 11 months old. I was and am on both tegretol and Lamictol. We had no birth defects or any withdrawl problems. I have been breast feeding him the entire time. He is bright, energetic, loveing, and really smart. I know every parent says that right? But my biggest fear after learning he didn't have any spinal tube defects was mental disabilities. The benefits of breast feeding I think far outweigh the slight possibility that medication might leak through. I take 400mg of Lamictol a day and 1000mg TegretolXR I say it's a personal choice, but please don't let fear be your deal breaker. I say try it and see waht happens. Please keep in touch with how your babies are doing. I'd love to hear from you both. ~Vanesa

Hello Everybody,my baby was born at the end of September anf I haven't logged in since, he is now sleeping 12 hours so at last I have some energy. Anyhow he was born perfectly healthy . I didn't breast feed and tried sma. He was a very poor feeder for the first two weeks and I think he was going through withdrawel because he was a bit jittery. However he caught up quickly and settled down. Ordinary SMA didn't suit him and he got constipated beyond belief no amount of water or oranged juice would sort it, then because he wasn't sleeping due to severe colic (not helped by constipation). Probably had an immature digestive system, this may have been due to lamictal but more than likely would have happened anyway. I was advised to try cow and gate omneo comfort milk. It is low in lactose, has fibre and is thicker. It worked a treat, I also add colief drops which are the lactase enzyme to break down the lactose. It works great, not a sign of colic and hge slept the night from when he was 7 weeks. A friend of mine is studying neurolgical development in babies and he is her test case, so far he is doing everything he should be doing at the right time so no sign of developmental delay at this stage.As regards me I survived without a seizure. Although it was extremely tough I was unbelievely tired after the delivery and I think my lamictal levels returning to normal after the birt affected me too. I was in a ward in the hospital, couldn't get a private room and it was dreadful I couldn't sleep. My advice to anyone and me next time is eat well during pregnancy. Get a private room in hospital, get someone in to do the housework and someone to help mind the baby so you can get some sleep during the day, none of which I did. I was ill with a womb infection after the pregnancy and began to develop depression when the baby was 6 weeks, however I now take vitamin B complex, a multivitamin and iron daily and ensure I get out and about and relax about housework it really doesn't matter and you need your sleep. So anyhow we survived it and so far all is well with me and the baby and long may it stay that way.Best of luck to you and please keep in touch with your news about yourselves or your babies.Happy New YearBugs Bunny

Hi congratrulations on your baby!  I had mine on 16th September by section - not because of the seizure in the end, but because, like my first he was stubbornly head up until the end so all things considered it seemed the best option.  I am photosensitive and rely, since my grand mal in July, on polarized sunglasses which I wore throughout my hospital stay (much to the amusement of the staff, I'm sure!) but I was told, just as I was going in for my section that I wouldn't be able to wear them which was a blow, but they were brilliant and covered my eyes during the op. so I didn't have any problems.  Finlay was fine, very healthy, with no outward signs of any Tegretol side effects or deformities and he went straight on to the breast, pretty much.  I have been very luck in that he sleeps like a dream and I haven't had to suffer sleeplessness at all - my husband gets up with my 5 year old at 7 and I sleep until a glorious 8.30!  I am a little nervous with Fin - I get nervous when I take him out in the sling - but I think I'm starting to regain my confidence.  I haven't had any more attacks - just a simple partial (or an aura - not sure how to tell the diff) a few weeks before he was born but nothing since, touch wood!  I am still on 600 mg and although I do worry about the long term side effects, I don't seem to suffer any at the moment.  Apart from my preoccupations when I'm alone with him (I am a natural worrier anyway), I am really enjoying it - he's a real joy.  Well, I just found this piece that I wrote after I had the siezure so I thought I ought to write and tell you how everything is!  I tend not to talk about my epilepsy to my family - preferring to live as normal life as possible and not to worry everyone too much, so it's great to have this forum as a necessary outlet!Rhiannon 

To everybody worrying about birth deffects: I was on dialantin with my 9 year old.  Can't remember how much but my neuorologist increased as time went on.  I do know it was a very high dosage.  One seizuze when I was about 3 months and rest of pregnancy was trouble free.  I did need a C section because she was too big.  I too had trouble breast feeding, and ended up supplementing with formula.  I had a seizure and dropped her when she was about 2 weeks old which was due to the hormonal changes according to my doc.   Anyway, she is now in a gifted and talented program at her school.  So all the meds haven't had a long term effect at least to this point.  Good Luck to everybody.

Hi Bugsbunny.Congratulations on your pregnancy from me,I hope that all goes smoothly for you.I cannot find the article that you cite, though I am willing to try, and then pass that article on. I suggest that you do a search as well upon this site, especially past posts regarding both JME and the topic of pregnancy as I did. I read those replies with interest, and wondered why there no more replies in this thread than there are now, as this in an emotive issue for women who have epilepsy (or one of the officially named classed definitions of epilepsy.)understanding the effects of AED's on mother and child is certainly an area that does worry any women of childbearing age, and research in this field is still ongoing, and divided in opinion as to the effects the newer drugs will have on mother and child. Standard thinking-known for a number of years does agree there is a risk, again quoted differently according to whose field your report author is sat in (for want of a better phrase) or even which country you are in.I welcome this five year study, and whislt I realise that is a long time to wait,I am hopeful that length of time will produce reliable and useful information that is -or will be of an acceptable standard to be of benefit in the future.'While our numbers are still preliminary, we are learning that some of the newer AEDs, like lamotrigine, cause less harm to the child, while it looks like others cause more damage," says Dr. Pennell, who is leading the NEAD study at Emory University. " We will have to wait until the study is complete, however, to know exactly which medications are best for fetal development."http://www.innovations-report.de/html/berichte/medizin_gesundheit/bericht-28585.html    

I read the post of yours with interest.Thank you for the link.I also did a search and wondered the same thing as well.JME has been discussed before in this forum I noticed,also pregnancy has as well.Perhaps the posters are now participating in Yahoo groups.  

hi!i'm new here. i'm fresh married and would like to get pregnent. my neurologist adviced to change my drugs from depalept to tegratol. i have done some reading on the net and it seams to me that lamictal is safer. i would love to read any opinion on this issue. thanks in advance. nunny

Hello to all,     I am new to this site, so hello to everyone! My husband and I are going to try to get pregnant in December, so I am doing tons of research about pregnancy and breast feeding also. I have simple partial seizures that started when I was 14. I have polymicrogyria which is the reason I have a seizure disorder. My seizures are very controlled, but I still have very minro seizures or aura episodes for about 30 mintues around three times a month, related to lack of sleep, stress, and hormones. I am on 450mg Lamictal, 4mg folic acid, and prenatal vitamins. I have been doing a ton of research and been talking to my neuro a lot, I actually go to Dr. Page Pennell, who if quoted a few posts up. She practices at Emory in Atlanta, and is really great. She is leading a ton of studies about the effects of AED's on pregnancy and breast feeding, so I feel very blessed to have her as my doc. I am going to be involved in her study once I am pregnant, which I am really excited about. Anyway, she said that Lamictal is THE safest drug to be on during pregnancy. She told me at my appointment last week that the Lamictal pregnancy registry was recently updated and the stats show that the birth defect rate for women on Lamictal monothearpy is only 2.9%! The birth defect rate for the average women is 2-3%. I was so excited and relieved to hear that!    This message board at the Epilepsy Foundation site is full of great information on pregnancy and epilepsy.  http://www.epilepsyfoundation.org/efforums/forum/categories.cfm?catid=4&flcache=9340316&entercat=y The "Can we get all the pregnancy updates here" thread is really informative. Anyways, here is a copy of one of my posts that includes the info I have found out about Lamictal and breastfeeding.    My neuro and OB/GYN told me that breastfeeding will be fine, that the amount the baby will receive through the milk is nothing compared to what they got during gestation. You just have to monitor weight gain and make sure the baby isn't sleeping 24 hours a day.     Here is a quote from her article in "Seminars in Neurology/Volume 22, November 3 2002""Breast-feeding with barbiturates or benzodiazepines may prolong sedation and feeding problems, and the newborn needs to be monitored closely. However, most infants of women with epilepsy can breast-feed successfully without complications...The benefits of breast-feeding are believed to outweigh the small risk of adverse effects of AED's." I skipped some confusing medical terminology and info!     These quotes are from the information sheets from the Epilepsy Foundation, which you can send for from this site somewhere. From the 'Health Issues After Your Baby Is Born' info sheet: "I want to breast-feed my baby. Will that be safe? For most women with epilepsy, breast-feeding is a safe option. All seizure medications will be found in breast milk, but this usually does not affect the baby who has been exposed already to the mother's medication during pregnancy." From the 'Epilepsy and Pregnancy' phamplet from the Epilepsy Foundation: "Will I be able to breast-feed my baby if I am taking antiepileptic medication? Yes, but with extra caution if you are taking certain medications that are more readily absorbed into breast milk. These medications are phenobarbital, primidone (Mysoline) and benzodiazepines (Valium and Lorazepam.) If you are taking just one of these medications, you can still breast-feed as long as you watch your baby carefully for any signs of excessive sleepiness. Certainly if your baby fails to gain weight because it is too sleepy to eat, you'll need to stop breastfeeding." From 'Perspectives in Epilepsy-Epilepsy in Women of Childbearing Age: A Clinical Perspective' booklet, which has opinions from Dr. Eugene Ramsay, Dr. Mark Yerby, and Dr. Antonio Delgado-Escueta: "Except for phenobarbital we see no problem with the nursing mother taking her anticonvulsant medication."  I hope this helps, and good luck to all those women trying for babies and congratulations to all those lucky moms out there!Stephanie

Stephaniethanks for all the information you shared with us. did you change your meds in order to get pregnant? how long are you taking lamictal? i hope it's not to private, i'm just wondering how long it takes to change to lamictal. good luck everybodynunny

Hi nunny,   As soon as I mentioned getting pregnant my neuro switched me from TegretrolXR (I think I took 400mg) to Lamictal (which I take 450mg) and pumped me full of folic acid, I was taking 5mg of folic acid before I added the prenatal vitamins, so I am only taking 4mg now since the prenatals have folic acid in them.  I honestly don't remember how long the switch to Lamictal took, my guess is that it took about two months. I remember that I had to do it gradually and overlap both meds at lower dosages for awhile. I have been on Lamictal for 2 years now, and have no side effects at all. I know that This week is the first week I have been off birth control meds for 2 1/2 years, and my neuro said that I might feel dizzy or have blurred vision because the birth control meds decrease the effectivness of my Lamictal, so I might have to lower my dosage, which will be fine by me!  I hope this helps! Stephanie 

I've been on 600mg of Lamictal a day and I am now pregnant.  The stats on lamictal and pregnancy seem to be pretty postive.  My concern after reading alot of these postings is that my doctor has never done a Lamictal drug level.  Is this necessary?  Is there anyone else who has never had a level drawn?

Hi Everybody.  I changed from Depakote to Lamictal about 3 years ago and I really love it.  I was on Depakote for 14 years and it really worked well for me but I gained a lot of weight when I started taking it.  When I switched meds I dropped 30 pounds!  It did take about a month or so, but it was well worth it.  I switched to lamictal because I want to have children.  I am 32 now and my husband and I have decided to start trying to have a child.  I have been terrified of having a baby because of concerns over what the meds might do to my baby.  I am so encouraged to hear about the 2.9% defect rate with Lamictal!  Does anyone know if there are any developmental delay issues with children born on lamictal? 

I am very happy to read this site. My husband and I are now considering trying to conceive within the next year. I want to wait a little bit, but I will see my neurologist six months before I decide to conceive. Anyway, my nephew has Cystic Fibrosis, so that added another concern to the list. I JUST got my results back from the blood test, however, and I am NOT a carrier for Cystic Fibrosis, so that's no longer a concern. So the only thing left is epilepsy. I haven't had a seizure in a little under three years and am currently taking 325 mg of Lamictal a day. I also take 1000 mcg of Folic Acid everyday, because my neurologist told me to. Well, anyway, since I found there was no risk of CF, my baby fever has grown. I looked up something on the subject and it said "Breastfeeding while on Lamictal is not recommended." However, many of you have encouraged me, and I especially feel better knowing that my medication is of a lower dosage. I REALLY want to breastfeed, and I really want to have a healthy baby. If I haven't had another seizure between now and six months before I'm ready to conceive, I'm considering asking my doctor to do a trial run and slowly decrease and maybe even see what happens when I'm not on it for a few months before I get pregnant. But now I feel okay about it even if that doesn't work out. 2.9% is a risk I can deal with. I had a 50% chance of being a carrier for CF, so maybe I'll get lucky both ways. Spygirljoan

Oh and by the way I read the article someone linked to about the five-year study -- and it said there was only a little over a year left in the study, so we won't have to wait that long!spygirljoan

Hello All....new member, I have epliepsy since birth, had only 3 or 4 grand mal szs. I have been on 250mgs Depakote almost all the time. My neuro took me off the medication when I first got pregnant in 1998. I took no medication for 3 months prior to getting pregnant and then throughout pregnancy. Had no problems what so ever, except a eposide of shaking after delivery.Laste year we decided to get pregnant for the second time. MY neuro put me on 50mgs of Lamictal. I did not have any problems with the szs, but had some bad eposiodes of panic attacks. The neuro gave me Paxil to combat the panic attacks but that did not help. So we gave up that attempt to get progrnant.Now we are planning on another child, my neuro has swithced me from 250 Depakote to Lamictal. She started me small with 25mg daily dose and has increased it now to 100mgs/day. But I still get the panic attacks. A simple task like rinsing dishes has become difficult to handle. I am on Paxil, but that does not help a bit. I am thinking of going back to depakote and give up on getting pregnant.Has anyone else had any similar experiences with Lamictal ?. I have been taking Lamictal this time for about 3 weeks, di I need to give it more time for my biody to adjust to the change in medication?. Thanks ! .  

Nicelady...Don't be so quick to give up on another pregnancy.  May daughter was on Depakote for 8 years.  Her dosage was the same as yours.  She has a really good doctor and he talked several times to her about becoming pregnant while she was on the drug.  It's true there could be a higher rate of some birth defects.  but he felt the dosage she was on was not so large that the percentage was low.  He did tell her to plan, plan and plan the pregnancy so they would run tests on the baby as early as being six weeks pregnant.  If anything really bad showed up they could determine what to do at that time.  Spinal Bifida was the largest risk and even now he feels with them doing infeto and repairing the spine before a baby is born that even that can be corrected.  (That is being done at Venderbilt in Nashville and now have enough cases to document the childrens progress.  People magazine had an article on it about 5-6 years ago).  Anyway, she really did well on that medicine.  She is planning on becoming pregnant next year and is on a pre-natal vitamin and large dosage of folic acid already.  Her ob-gyn has asked that she try the Lamictal and see if they work and go on it instead of the Depakote.  She has finally gotten weaned into the Lactimal and we will see in time how it is working...before she gets pregnant.  She has told me several times since then that she really trusted her neur. and would have had children anyway on the depakote.  She just really would have had every test she could have.  And I tend to believe that the dosage was not huge and chances weren't as great as if she was on a much larger dose and that the doctor would have watched her pregnancy closely. 

Hello all-I am new here - I am 32, my husband and I are going to try to start a family. I have epilespy, and was diagnosed when I was 10. I have been on every medicine there is - which the exception of the newer ones that came out in the past five years. I am currently on Depakote - 1500mg a day. I have been seizure free for over 6 years, and that seizure was due to a low level on my part. We went and saw my Neuro, he suggested that I switch over to Lamictal (which takes about a month to switch over??) My doctor has also referred us to one of the best ob/gyns in the city, who has a great knowledge of epilespy for an ob/gyn (supposely he is one of the best in the city)We are extremely nervous, for my health, and our future babies. Doctor's are fine, and tell you things to make them safe, but as we all know, nobody knows our bodies better then ourselves.If anyone could give me any advice, wisdom, anything, we would appreciate it. Anything about the meds?Thanks so much, and keep wellLori

Hi. I am 23 and my husband and I are expecting our first child.  I've been on Lamictal for a while and I only have praises for it.  My personal experience has been wonderful.  I know it takes a while to ease on to the meds, but, for me at least, it was worth it.  I had been on Depakote for about a year and a half (I was 16 when I began meds) and I experienced side effects from it which made me frustrated.  I was switched to Lamictal after speaking to my doctor and have loved being on it.  I didn't understand the slow process of getting on Lamictal, but I did know that I didn't want a skin rash(the side effect of getting on the meds too quick.)  I hope it works for you as well as it has worked for me.

Hello Bugsbunny,I was a little disappointed with some of the replies you received about breast feeding. I also took lamictal during my entire pregnancy and during my current pregnancy right now. I am 14 weeks along.  I am currently taking 600mgs a day compared to the 450mgs I was taking before pregnancy.  I did breast feed my son and plan to do the same with my new baby.  I was so nervous to because I was afraid that it would harm my son, but I was informed by my Neuro and OB that there is a VERY SMALL AMOUNT of Lamictal that the baby will get from your breast milk compared to what he or she was getting in the womb. So my worries were put to rest.  I feel so strongly about the benefits of breast feeding and could not imagine giving my son formula. I really  feel that you get such a close bond with your child. As you may have noticed I really feel strongly about breast feeding.  I feel as does all my doctors that the benefits REALLY outweight the risks. My son is currently 14 months old and was breastfed until he was 13 months old.  He was exclusively breastfed until six months and then I supplemented with solid food.  I was really sad the first time I gave him solid food.  It was such a wonderful feeling that my son relied totally on me to be nourished.  Now he didn't need me as much. One other thing that really bothered me about formular is that is what it really is a formular and I really feel there is no way to compare to what the child would get from breast milk.  As far as my son his developmental skills are right on track with babies his age and some things he was advenced.  He is PERFECT.  I can't imagine having done things any differently reguarding breast feeding.  I hope I was able to ease your worries about breast feeding.  If you have any other questions please feel free to email me at amys2b@charter.net.

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.htmlThe 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.  

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

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?

Hi Everyone-Well- had the baby Aug 3rd via unplanned c-section, but that has to do with the way I am built instead of any problem with siezures or medication.  The baby is fine, beautiful, alert- everything you could want in a child. I had his Lamictal levels checked at 5 days old- I had been breastfeeding him all along.  Just got the results back- it is ***LESS THAN 1 MICROGRAM PER LITRE OF BLOOD**** in my baby. The pediatrician said that counts as "barely perceptible" in his bloodwork.  I can't interpret what that means for my son- the data just doesnt seem to be out there- but I can only make my decision to breastfeed based on what I find.  I will continue to breastfeed...armed with the current information, I really think the benefits outweigh the risks at this point. I plan on re-testing his blood after a month of breastfeeding to see if his Lamictal levels have increased, decreased or stayed the same...I will let you know. I hope this helps someone out there.

Congratulations on your beautiful, healthy baby.  That is great news for those of us who want to have children while on meds. Thank you for sharing your good news.  I would love to hear more updates when you find the time!  Good luck.

Congrats on your new baby!!!It was so nice to read your post on the info you got about the lamictal level in your baby.  My son is now 15 months old and even though he is doing great I still wonder how much lamictal he got when I breastfed him.  THANKS SO MUCH for posting.  It is really nice to get firsthand experiences related.  I have another child on the way and plan to breast feed again. Thanks again and please keep us informed of any new info you get about lamictal and your baby.  Take care!!!

hi i read ur note  and i understand a little bit of what u are going through,i myself am not on that medication but i have been advised by my doctor to come off my medication,i was on epilim and the doctor said it would be a danger to keep on it ie for my baby such things like spina bifida or cleft palate.so the doctor had to withdraw me off my epilim,which took 8 months,i have now been drug free for 7 months,which is good going,and me and my partner are trying for a baby,back to your question,the doctor was telling me about a new drug,well is been out about 5 years,anyway i have same corncerns as you about breastfeeding,if i have a fit,i have asked him to put me on this new drug,as you can breastfeed on it with no harm to the baby,i will find out for u what its called and will get back to you,hope my info as been helpful to u.miss kitty.

I am not a doctor but I have read alot about epilepsy and being pregnet. There are alot of risk in general regardless of your medication. they are small risk most of the time but there are still risk I would highly advise that you talk to your doctor and see what he thinks he would be your best bet. this could be dangerous for your baby.

Liporace is my doctor and I have been with her for 15 years. She is an excellent doctor. She is a woman doctor and deals with pregnancy,  hormonal issues, epilepsy...I was on lamictal but after I was done having my children. I did not breastfeed because of my meds, but that was 22 and 15 years ago. I hear now adays, depending on what meds you are on you can breastfeed.But I would talk to your doctor before you breastfeed your baby.take careLisahttp://health.groups.yahoo.com/group/EpilepsyApproach/

Hello all

This is my first time on this or any other discussion forum. I have a story to tell and I apologise in advance for the length of it but I hope that you enjoy it and find it helpful.

I was diagnosed at the age of 17 with JME. I was put on Epilim and I never had another seizure. I was always careful to get plenty of sleep but otherwise I led a totally unrestricted lifestyle. When I was 25 I had a breakthrough seizure when I tried to come off Epilim but I went back on it and again once I was on it I was perfect. I am a qualified accountant, have had very high powered jobs, travelled the world and never felt vulnerable or restricted because of my epilepsy......until I wanted to have a baby.

3 years ago I got married. I had procrastinated on the pregnancy issue for a year prior to that and decided that it wasn't a good idea, I was too selfish, didn't want the inconvenience etc. But deep down I longed for a baby and was in denial simply because I knew that I was heading for dangerous waters. I researched long and hard and sought any information that would help me to make my decision. I read so many discussion boards but could never bring myself to join in. I found out many things during my research but the one overriding glaring issue was that Epilim was not the best option for pregnancy, however there were lots of women who had perfectly healthy children while taking Epilim. I knew that the first thing that I had to do if I was to get pregnant was to come off Epilim and take something else. I was utterly terrified - probably as terrified as I was when I had my first seizure when I was a teenager.

With my neurologist I was weaned off Epilim on to Lamictal - slowly at first introducing 25mg of Lamictal a day then progressing to 50mg etc. etc. It took 3 months in total and no seizures. I also started taking 5mg of Folic Acid daily. I can't remember exactly what my dosage was but I think it was 100mg at night and 75mg in the morning.

I got pregnant straight away so there were no fertility issues. My Obstetrician was very supportive and really didn't make anything of it. He had many patients who were on different AEDs and there were rarely any issues. I have to say though that I became a "scan-o-holic". But again, my obstetrician was very patient. My pregnancy progressed normally and I had absolutely no problems what so ever. I had chronic sickness for the first trimester but I thrived and glowed right up to delivery.

I went into labour naturally about 2 weeks before due date. It was a long labour but that is not unusual on a first pregnancy. I gave in to an epidural when I was 6 cm's because of total exhaustion (I had been in labour for 14 hours at that stage). My baby was deivered vaginally but assisted with a vacum as he was presenting face up rather than down.

This is the wonderful bit - my son weighed in at 6lbs 6 oz and utterly perfect. He had a high apgar score (this is a statistic for assessing the infants health) and both my obstetrician and the delivering midwives all commented on his alertness.

The Paediatirican and lactation specialists all recommended breast feeding and I was also keen, my only concern being sleep deprivation and potential seizures. I had volumes of colostrum so no problems with milk supply. My son was born hungry and it wasn't coming fast enough for him. He got formula as well as colostrum and the paediatrician was amazed at the volume of milk that he could drink in one go. He didn't latch well and I pumped breast milk exclusively for 4 weeks and gave it to him via a bottle. To put it mildly, he thrived gaining a pound every 10 days. He did not have colic, fed every three hours during the day and every 4 to 5 hours at night. So again, no problems on the breast milk.

He is now 2 years of age and a joy. Perfectly healthy and his devlopment is progressing very well. His speech and dexterity skills are that of a 3 year old but he only walked when he was 18 months. This is completely normal as children develop skills at their own pace.

My own experience has been generally positive. It's not all a bed of roses. While I have not had any tonic clonic siezures, I have had auras when I have been particularly sleep deprived. I found pumping breast milk completely unnatural and upsetting and very time consuming - an hour pumping, an hour feeding, an hour to myself and then pumping again. I am on 300mg of Lamictal now and it works very well but I do have to be careful with extreme sleep deprivation. I have a wonderful husband who will take the reins when necessary.

Last week we started trying for our second child and I am as apprehensive as any mother to be would be. But I do not carry the terror of brith defects with me as on my previous pregnancy. I am looking forward with anticipation and I am determined to breastfeed if the baby goes for it.

Just on another note - I have never had my blood levels checked and nor did my son. I can only presume that it is not necessary unless there is something amiss.

Hope you enjoyed my tale and that you all can take something postiive away with you from it.

Lily

lily

HI EVERYONE IM NEW AND GLAD I FOUND THIS WEBSITE.IM 23YRS OLD AND 8 WKS PREGNANT. IVE HAD EPILEPSY SINCE I WAS 14 YRS OLD.I WAS ON 500MG TEGRATOL FOR THE FIRST 5 YRS AND HAVE BEEN ON LAMICTAL FOR THE PAST 5 YRS. IM CURRENTLY ON 200MG A DAY, WHICH IS HARDLY ANYTHING BUT MY FEARS OF BIRTH DEFECTS R STILL THERE.I HAVENT HAD A SEIZURE FOR 2 YRS. THANK GOD...IF ANY OF U HAVE ANY ADVICE ILL REALLY APPRECIATE IT.

I was pregnant while on Carbamezapine and breast-fed for 9 months and my baby is fine. My Neurologist said that the amount that goes into the breast milk is so minut that the baby won't be affected or expience withdrawal. I was just on Lamictal b/c I want to get pregnant again but I didn't like how I felt on it so I went off. Back on Carbamezapine now. But the Neurologist said that Lamictal was the safest and you could also breast-feed while on it also. I have no worries with my next one. I also took loads of folic acid everyday to prevent birth defects.

Hello,

I also took Lamictal all throughout my pregnancy. I wasn't aware of any effect during the pregnancy. But, I knew I wanted to breastfeed desperately. I did a lot of researching and I talked with my doctors. Neither my OB-GYN, ped. or neurologist said a definate no. But, no one said yes either. Because there has never been any tests on humans, the drug has been rated C. I think that is it. Anyways it means that the side effects are unknown and because of that it is recommended that you don't breastfeed. I struggled with all of this information all thruough out the pregnancy. I would say no I am not and a month later I would say yes I am. Well, my son is now 14 mo. and I breastfed him until he was about 11 mo. He is 100% healthy. And the picture perfect little man (whell that is what I think :) )
My decision was based on what I discovered in some research. I read that the drug Lamictal passes into the umbilical cord and to the baby. Well, I too, did not want my son to abruptly come off of the drug. So, I thought that me breastfeeding would kind of help that. And, I don't even know if that is what was supposed to have been done or how he would have been if I didn't breastfeed him. But, I just thought that I would share my situation with you. I hope that all is well.

Iam very much thankfull to all the replys i gone through all the replies and just to convey my thanks to all of you i registered to this site immediately.
As my Wife was Pregnant she is now 6 weeks pregnant she is taking Lamictal from more than 6 years and we are very much worried about our baby growth and baby health after reading all of your comments iam very happy and today really i will go in a happy mood to home and share this with my Wife.
Once again Thank to One and All.

Hi,

I am a new mom with a newborn just 16 days. I started breastfeeding four days after he was born when I began to have a little bit breastmilk. Then I noticed my baby was very sleepy and would sleep through the night for 8 or 9 hours. Immediately we thought of the possibility of lamictal causing the drowsiness. At day 10 after birth we did a blood test for him and the lamictal level in his body was 4.2. I was on 600mg/day lamictal before pregnancy and 1100mg/day at delivery. Now I am 800mg/day. Lamictal level in my body was 5-7, really close to his. We were recommended by peds not to breastfeed or at least add formula. But my neurologist insisted that it's safe to breastfeed. Since we are still concerned about it, we started formula only 3 days ago and found him much more active and would wake us up in the midnight for hungar. 

Then I read the artical "Concerns regarding lamotrigine and breast-feeding" recommended by bugsbunny(Thank you so much). It said that one important factor was negalected that infant has poor ability to metabolize lamictal, two nursing infants still have the same level of lamictal after two months of birth. For adult, the half life of lamictal is 29 hours. Although not enough systematic data to get a final conclusion yet, it is recommended not to breastfeed.

We continued formula only feeding and will recheck his blood level of lamictal next week to see whether he is able to clear off the drug. I will definitely come back with the results I got. But it is also important to know the drug metabolism is different in every infant and mine may not suit your situation. Some baby has even undetectable drug level vs 4.2 of mine. So I recommend checking the durg level after you deliver and recheck again afterwards whatever feeding you want to do.

Overall, my feeling is breastfeeding should not be encouraged not just because no major health problem being recorded. Long-term effect is hard to tell even if your child is healthy so far. Why give him the drug he does not need and cause you such a big cocern.

 

 

I read one person being concerned about being on Lamictal and Paxil.  Well, I'm on Lamictal and Zoloft and am 22 weeks pregnant with nothing wrong thus far!  Both meds have the lowest level of risk for birth defects.  So if Paxil isn't working for you, try asking about Zoloft or something else instead.  I'm only taking 400 mg of Lamictal daily along with 3 mg folic acid, and 50 mg Zoloft.  I have to have blood tests done once every month to make sure the Lamictal levels are between 2 and 20 in the blood.

 I have only had one seizure my entire life when I was 24 (Nov. 2008) and thankfully none since!  It's now Nov. 2010.  I found out I was photosensitive epileptic and loved the idea one mom had about having her eyes covered during delivery since the hormones are going crazy then and there's no telling what can happen.  I'm also going to be asking about having to take extra vitamin K during the last month or week of pregnancy due to other testimonies on here.  I love that this forum has talked about breastfeeding because I very much want to do that!  My neuro isn't really for trying because of the fear of the affect on the baby.  However, I'll discuss this with my ob-gyn this coming week.  I want to at least try since others on here have been successful and just be aware to watch for excessive sleepiness after my son is born.  I can't promise that I'll make an update here later simply because I'll probably forget.  I sincerely hope I'll be able to breastfeed and be another success story like the other moms!  If not, then formula and goat's milk will be options I go for.  Probably homemade formula, which might be cheaper. Who knows?  

 Good luck to all the other moms and moms-to-be who find this forum later!  I hope all goes well for everyone!

I was on 300 mg lamictal before i got pregnant. When i was pregnant, my neuro increased my dosage to 600 mg due to seizures. I had about 6 seizures during the pregnancy, which was the most seizures i ever had within 1 year. My neuro also pumped my folic acid dosage to 10mg. The fear of spina bifida and cleft pallete haunted me throughout the entire pregnancy. Luckily my obgyn told me everything is normal and there's no sign of birth defect. My baby was delivered via elective c-section. It was the fear of exhaustion from labor that may cause seizure that made me decided to have c-section instead of natural delivery.

As for breast feeding, both my neuro and pediatrician didn't recommend breast feeding due to the amount of lamotrigine in the breast milk. I did however, breastfed my baby for about 2 weeks for all the colostrum. But then I stopped after 2 weeks because i was intoxicated by the high dosage of Lamictal. It was terrible because i couldn't remember things that i did, had terrible headaches and vomitting non stop. When I told my neuro about the symptoms, he decreased my dosage down to 300 mg. I felt so much better after that, but the fear of having my baby experiencing withdrawal, etc I decided to stop breastfeeding. She is 13 months old now. Very healthy and alert little girl who hit all her milestones early.

Don't be afraid to get pregnant, enjoy it but be more cautious because you may get seizures due to raging hormones (in my case).

Doctors are now saying not to worry about breastfeeding. At least that is what my neurologist has been telling me.

Hi all,

 I am currently 16 weeks pregnant with my first child and take 800 mg daily of Lamictal. Prior to pregnancy I had not had a seizure for 15 years, recently I have been getting weird dizzy spells (which I never got before, even when I was having seizures). I am going to the neurologist in a few weeks to ask him what is going on. I'm thinking he might raise my dose, not sure if that is a good course of action though..I'm not sure if that would put the baby at more risk because I already take a fairly high dose.

 As far as breastfeeding goes, I have made the decision not to breastfeed, as I don't believe there is enough research done to indicate that the baby will be alright. I had spoken to my neurologist prior to getting pregant and he said the choice is up to me, as there is conflicting research about the effects that it has on the baby. I am very glad to hear so many mothers who took Lamictal and had healthy babies. That is my biggest fear, that my baby will be born with a birth defect because of my medication. I'm trying not to worry but it's so hard!!!

I am 28 and have epilepsy.
I have been on Lamictal in the form of Lamotrigene for quite some time now (200 mg twice a day)and had my daughter in 2008. During pregnancy I felt like myself again, I hadn't felt that way since I was a child. I was followed by a neurologist for the majority of the pregnancy complete with med level checks and labs for liver function. I was also VERY careful about taking the lamotrigene, pr