After the Baby Is Born


The time right after you have your baby (also known as the postnatal or post-partum period) can be both exciting and stressful. Plan for how you can safely care for you and your baby. Taking steps to care for you and your baby will help ease any worries you have about what will happen after giving birth. After giving birth, you can ask for help from other adults. Ask your partner, family, friends, or a hired caregiver to assist and support you and the baby.

Create a postpartum plan for care that includes:

  • How to safely carry, bathe, and change your baby.
  • Safe sleeping arrangements. This includes never sleeping in the same bed as your baby.
  • Making sure you get enough sleep. Aim to get at least one uninterrupted four to six-hour stretch of sleep at night and an additional two hours of naps during the day to reduce the risk of seizures.
  • How you’ll feed your baby. Research shows it’s safe to breastfeed when you take anti-seizure medications (ASMs), and breastfeeding is beneficial for both you and your baby. There are very few exceptions.  
  • Restarting birth control as soon as possible after giving birth to prevent an unplanned pregnancy.
  • Consult with your child’s pediatrician if you have any concerns about your child’s development. 

Your body typically eliminates ASMs faster when you’re pregnant, so certain ASMs may require higher doses during pregnancy. If you increased your dosage during pregnancy, you’ll work with your doctor on a plan to bring it back to your pre-pregnancy dosage (or slightly higher) after delivery. An ASM tapering plan is crucial. It will help prevent potentially serious side effects of maintaining a higher-than-needed dose after pregnancy.  

Your tapering plan may involve keeping you at a slightly higher dose than your pre-pregnancy dosage for a short period following delivery. This higher dose can protect you from the effects of sleep deprivation and other stressors.

If your ASMs were increased during pregnancy, you may be at an increased risk for side effects after you deliver. These may include vertigo, vomiting, blurry/double vision, and gait imbalance when the blood levels of their medications are changing rapidly. If you encounter any of these symptoms, reach out to your doctor right away or visit an emergency room if you feel your symptoms are severe. 

After bringing your baby home, there are many things you can do to prioritize your baby’s safety:

  • Make a safe sleeping arrangement plan that follows the American Academy of Pediatricians guidelines:
    • Never sleep with your baby.
    • Putting your baby to sleep in a separate bassinet or crib.
    • Putting your baby to sleep on their back. Do not put soft toys, pillows, blankets, or other bedding in the bassinet/crib with the baby.
  • Make a dedicated baby care space on a single floor of your home. Staying on one level will limit how often you must carry your baby up and down stairs.
  • Keep the baby safe while carrying them even if you have a seizure.
    • Avoid carriers that use straps that attach the baby to you.
    • Use a stroller to move the baby around the house.
  • Sit on a low chair or the floor when feeding or changing the baby to reduce the risks of falling if you have a seizure.
  • Keep the baby safe during bath time in case you lose consciousness or awareness.
    • Only bathe the baby when another adult is present.
    • Bathe the baby in a sink or infant bath.
    • Only take tub baths yourself when another adult is present.

When planning for your pregnancy and before your baby’s birth, you’ll want to decide on a feeding plan. Think about if you’ll breastfeed, use baby formula, or a combination of the two.

Breastfeeding is safe for people who take ASMs under supervision throughout their pregnancy and while they breastfeed. There’s little evidence that ASM exposure from breastmilk has clinical effects on newborns. You can safely breastfeed while you’re taking your epilepsy medication. There are very few exceptions. For example, benzodiazepines (like clobazam and clonazepam) or barbiturates (like phenobarbital) may cause sedation in newborns. If you are taking any of these medications, please discuss breastfeeding with your epilepsy care team and develop a plan with your baby’s pediatrician.

Formula is also a healthy and effective way of feeding that supports babies’ growth and development.

It is a myth that you cannot get pregnant while breastfeeding. Regardless of whether you are breastfeeding, you should restart your birth control shortly after giving birth.

In the general United States population, approximately 50% of pregnancies are unplanned. Some studies found that up to 65% of women with epilepsy reported at least one unplanned pregnancy. Consult with your doctor or your OB-GYN during your third trimester about a plan to restart your birth control once your baby is born.  

Please note that it’s recommended to avoid estrogen-containing birth control options for the first six weeks after having a baby. This helps to prevent deep vein thrombosis which are deep blood clots that usually form in the legs. 

Caring for a new baby can be challenging. Consult with your epilepsy care team if you have concerns about how to best care for your new baby at home. If you would like to try to get pregnant, work with your care team as early as possible. The team will help you create a plan that includes safely caring for your baby. Educating yourself about safe baby care practices before you bring your baby home can make the postnatal period less stressful and safer for you and your child. 

Authored By:

Naymee J Velez Ruiz, MD FAES

on Tuesday, November 28, 2023
on Tuesday, November 28, 2023


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