I agree that sumatriptan is not a concern.  I have had several mothers use
it without problem for the nursing infant.  Waiting four hours is
unnecessary, even if the mother did want to make sure most of it is out of
the body before feeding the baby.  It has a short half life, probably about
1 hour, so that even two hours after a SC dose, 75% of it is out of the
mother's body.  This is probably not necessary, though, as blood levels are
low, and *oral bioavailability* is also low.

I am not sure what the latest is on long term treatment.  But some old
approaches are often useful.  Propranalol has helped many people with
frequent migraines.  It is not the answer for everyone, but worth a try,
especially since it is compatible with breastfeeding.

I am sure there are other non drug approaches to dealing with migraine.

Jack Newman, MD, FRCPC