Breastfeeding during anti-epilepsy drug treatment does not appear to harm a child's cognitive development

A first of its kind study finds breastfeeding while taking certain seizure medications does not appear to harm a child's cognitive development. The research will be presented at the upcoming American Academy of Neurology 60th Anniversary Annual Meeting in Chicago, April 12-19, 2008.

"Our early findings show breastfeeding during anti-epilepsy drug treatment doesn’t appear to have a negative impact on a child's cognitive abilities," said study author Kimford Meador, MD, with the University of Florida at Gainesville, and Fellow of the American Academy of Neurology. "However, more research is needed to confirm our findings and women should use caution due to the limitations of our study."

Researchers tested the cognitive development of 187 two-year-old children whose mothers were taking the epilepsy drugs lamotrigine, carbamazepine, phenytoin, or valproate. Forty-one percent of the children were breastfed.

The study found breastfed children had higher cognitive test scores than those children who were not breastfed, and this trend was consistent for each anti-epilepsy drug. The children who were breastfed received an average test score of 98.1 compared to a score of 89.5 for the children not breastfed. However, the results were not significant after adjusting for the mother’s IQ. Thus, it appears that the higher scores in children who were breastfed is due to the fact that their mothers had higher IQs.

Meador says animal studies have shown that some anti-epilepsy drugs, but not all, can cause cells to die in immature brains, but this effect can be blocked by the protective effects of beta estradiol, which is the mother’s sex hormone. “Since the potential protective effects of beta estradiol in utero are absent after birth, concern was raised that breastfeeding by women taking anti-epilepsy drugs may increase the risk of anti-epilepsy drug-induced cell death and result in reduced cognitive outcomes in children.”

Meador says additional research on the effects of breastfeeding should be extended to other anti-epilepsy drugs and mothers who use more than one anti-epilepsy medication.

The study is part of an ongoing study of the long-term effects of in utero anti-epilepsy drug exposure on children’s cognition. Women with epilepsy who were taking anti-epilepsy drugs were enrolled in the study during pregnancy. Ultimately, the study will examine the effects of in utero anti-epilepsy drug exposure on children at six years old.

The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, epilepsy, multiple sclerosis, Parkinson’s disease, and stroke.

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