BREAST-FEEDING, WEIGHT-GAIN AND BEHAVIOR IN NEWBORNS OF EPILEPTIC WOMEN

Background. In active epilepsy regular therapy with antiepileptic drug s is necessary even during pregnancy and lactation period to prevent s eizures. Antiepileptic drugs pass through the placenta to the fetus an d after delivery also into mothers' milk. In the study on ''Epilepsy, pregnancy and the child'' we examined wether mothers with antiepilepti c therapy want to breast feed and wether breast feeding is advisable f or those infants. Methods: 48 epileptic women with antiepileptic drug therapy and their 48 respective controls were asked before delivery if they intended to breast feed and after delivery how they nourish thei r infants and the reasons for ending breast feeding. In all the neonat es weight as well as symptoms of apathy and hyperexcitability were ass essed regularly up to 4 weeks after birth. Results: Woman with epileps y stopped breast feeding earlier, fed breast milk by bottle more often and explained this by sucking difficulties of the neonates. Their neo nates mean birth weight was comparable to that of the controls, but at 4 weeks later their weight was significantly lower; 12.5% of the infa nts were even dystrophic at that time. The type of feeding did not inf luence weight gain. Most neonates of epileptic mothers were apathic du ring the first days after birth, we assumed this to be due to sedation by the antiepileptic drugs. Sucking difficulties improved after mothe rs stopped feeding their breast milk. After their first days neonates were often hyperexcitable most likely due to withdrawal of antiepilept ic drugs, these symptoms were not mitigated by feeding infant formula milk. Conclusion: Women with epilepsy and antiepileptic drug treatment may breast feed as long as the infant is sucking well and weight gain is satisfactorily.