Levetiracetam and breastfeeding

[Mine24]

I suffered an ischaemic stroke in May 2020 but was left with no residual neurological deficit. I had a baby on 6 July 2021 and there were no complications during the pregnancy. On 9 July 2021, I had a seizure where I lost consciousness and bit my tongue. This was my first experience of having a seizure. My blood pressure was also very high and has been fluctuating since. As it was 3 days post-partum, there was a query of whether I suffered an eclamptic seizure or an epileptic seizure. I have been referred for an EEG but I am still waiting for the appointment. I suffered another seizure on 18 August 2021 where I also lost consciousness and bit my tongue and I have no recollection of what happened. I have been lucky to see a neurologist and they are of the view that due to having suffered a past stroke, I am at an increased risk of having further epileptic seizures. I have now started on levetiracetam 250mg to be increased to 500mg twice a day. I would appreciate any advice from anyone who is on Levetiracetam and is also breastfeeding as I have not been able to get any firm confirmation from the neurologist if it is safe to breastfeed while on this medication. The patient information leaflet states that breastfeeding is not recommended so I am not sure what to do

[EpilepsyAction1 Partner Epilepsy Action]

Hi Mine24

Firstly congratulations!

If your doctor or health visitor says your baby is healthy, levetiracetam can be taken while you're breastfeeding.

Levetiracetam passes into breast milk in small amounts, which means your baby will get a small amount of your medicine when they feed. It’s rare for side-effects to be reported in breastfed infants of mothers taking epilepsy medicines. However, if your baby is very sleepy, hard to wake, struggling to feed, or has a rash, talk to your doctor urgently. They might advise you to stop breastfeeding and start formula feeds to see if your baby improves.

epilepsy.org.uk/info/daily-...

nhs.uk/medicines/levetirace...

I hope this helps to reassure you.

Regards

Diane

Helpline Team

[pegasus3]

Hi, I am on both levetiracetam and lamotrigine. Both my youngest 2 were breastfed, one for 5 months and the other for 2 years. My consultant described it as baby is exposed to much lower levels of the medication through breastmilk than whilst intrauterine. My specialist nurse advised that baby can get a bit drowsy, particularly when the drug levels are at their highest which is usually about 2 hours after taking your medication. I was able to time taking my meds around the feeds to avoid that. If not, express when drug levels would be low and give a bottle of expressed milk, then pump and dump if needed when drug levels likely to be high

[Mine24 in reply to pegasus3]

Hi pegasus3,

Thank you for replying. Your advice about timing the feeds is very helpful. I have only been on the medication for 9 days now but will try to time my feeds to when the drug levels are lower in my system. I did read that some of the side effects is baby being sleepy, hard to feed and a rash which makes me a bit anxious about breastfeeding. I also read that Levetiracetam is a fairly new drug so I am quite conflicted about whether to continue breastfeeding or not as the longer term effects are unknown . I wondered if you don't mind, if you could share your experience of taking anti epileptic medication while raising your children.