I have just searched the archives and found no definitive answers re: the
use of Neurontin with breastfeeding.  This patient is also on Buspar 15 mg
TID. The baby was delivered at 35 weeks gestation via C/S due to PIH. In
investigating the appropriateness of this drug I researched Hale,
Micromedex, the Lactnet Archives and our hospital pharmacist.  With the
exception of one post, all of the recommendations were neutral. From our
hospital pharmacist I obtained the following information.

"Neurontin looks like a hard one to call, it has the low protein binding but
the bioavailability of it drops as the dose goes up and the 800mg tid is a
pretty hefty dose so I'm not sure what % of it is even bioavailable to cross
into the milk.  76-81% of it is excreted by the kidneys which indicates it
is fairly water soluble rather than lipid soluble further decreasing the
amount we would suspect reaches the milk.  While we don't know how much
would pass into the milk, the type of effect would we expect to the infant
is mostly CNS (sleepiness, dizziness, etc) so it may be worth a try since
the benefit may outweigh this risk.  There is dosing recommendations for
kids as young as 3.  Timing of the feeding just before a dose or at least 3
hours after may help."

One of our neonatologists stated that he did not want the mother to nurse
her baby because of the unknowns re: brain development which is what this
mother has been instructed to do.  His daughter was on the medication and it
affected her adversely.

If there are any private posts in response to past posts on Neurontin that
would support breastfeeding while on this medication, please post to the
group.

Thanks so much for your help.

Chris Raasch
Menomonee Falls WI

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