Kim Meador, MD of the University of Florida and colleagues, in a study of 187 children of mothers being treated for epilepsy, found that infants and children exposed to commonly used antiepileptic medications via breastmilk had slightly higher cogninitive scores at two years of age compared to children who were bottlefed.

The preliminary results were published as an abstract and presented at the American Academy of Neurology Annual Meeting in Chicago, Illinois. The findings are part of an ongoing study of the Neurodevelopmental Effects of Antiepileptic Drugs (NEAD).

The data suggest that women can safely breastfeed while taking antiepileptic drugs, but given the small sample size and the observational nature of the study, caution is advised until the findings are confirmed by other studies.

“It is not definitive, but at least it’s a start,” Meador told Medpage Today.

Animal studies show that antiepileptic drugs kill neurons in the brain. But estrogen is thought to block the effect in humans—a theory supported by the NEAD data.

The study was originally designed to determine the long-term effects on infants and children of in utero exposure to the commonly used antiepileptic drugs Tegretol, Lamictal, Dilantin, and Depakote. There were 311 infants in the original study sample, but two years later, only 187 children remain. The majority of children were not breastfed (58 percent), however, those who were, scored higher on the Mental Development Index (MDI), than those who were not. Children in the study will continue to be tested for neuropsychological effects through six years of age.

Given that the safety of antiepileptic drugs during pregnancy and lactation has not been well-established, it is best to talk with your and your baby’s health care provider before taking any medication—even those thought to be safe. Resources for sound information on the safety of drugs during lactation include LactMed an online database and Medications and Mother’s Milk by Thomas Hale.