We already know that people have a staggering number of things to think about when planning to have a baby, but for people with chronic health conditions such as epilepsy there are additional things to consider. This includes making sure that both their health and their medications are right for them and their pregnancy before conceiving.
After conception comes thinking about what to buy, who will take what parental leave and what post-pregnancy life might look like, but there is extra planning for pregnant people with epilepsy. They have to plan how they can get enough sleep as well as thinking about how they will bathe, carry the baby downstairs or push a pram if they have active seizures. If these are questions you are asking yourself at the moment there are a list of websites below with some helpful information.
Post-natal planning also includes an important set of considerations about how to feed the baby: Is Breastfeeding or formula best? Or a combination of both? All new parents need to make this choice (and this choice may change along the way), but for soon-to-be new parents with epilepsy they have an added consideration: Can I breastfeed while taking my medication?
This is an important question which should be discussed with a health care professional when pregnant or even before pregnancy. Last year a group of international epilepsy experts1 wrote a scientific review paper suggesting that:
The amount of medication in breastmilk is low for most of the medications.
There is no evidence currently that breastfeeding your baby causes your baby to develop more slowly or cause them health problems (probably because the levels in breastmilk are so low).
Breastfeeding has a number of benefits for the parent and the child.
However, they did say that they did not know the safety profile of each individual medication yet and that we still need to study this further.
At the UK Epilepsy and Pregnancy Register we have been learning about the health and development of babies exposed to epilepsy medications in the womb. Now, with the help of ERUK, we are turning our attention to understanding whether breastfeeding your baby on antiseizure medications is associated with similar health and developmental outcomes to those who are not fed via breastmilk.
Whether or not to breastfeed is a decision based on a number of practical considerations as well personal preference. In the future, we hope to be able to provide women with the information they need about their specific medication (or combination of medications) to help them navigate these decisions more easily (……at least the parts of the decision linked to antiseizure medications anyway). We might not be able to advise on the correct pram, cot or how to handle awkward gifts from distant family members, but we would like to be able to provide more complete information about feeding your child while taking epilepsy medication.
We will use this pilot grant from ERUK to start to learn about how to best investigate this important topic. We will recruit around 100 pregnant people with epilepsy and to find out how many decide to feed their baby via breastmilk and how long for. We will also follow up participants and their babies to understand how best to investigate their development in a larger study, setting us up for the future.
Useful Information
For useful information about planning your pregnancy or making decisions about how to feed your baby please seek to your health care professional and check out these resources:
Join Our Current Study
We are currently enrolling pregnant people with epilepsy to understand about the health of their children and how they develop during childhood.
Whether you are on antiseizure medications or not, you are welcome to take part.
If you are reading this and are interested to help out by taking part please email us at: UKEPR@manchester.ac.uk.
Written By:
Rebecca Bromley PhD, Paediatric Neuropsychologist and Senior Research Fellow into the developmental outcomes of children born to people with epilepsy.
Beth Irwin RGN, Epilepsy Nurse Specialist and Midwife and investigator on UK EPR breastfeeding pilot.
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