Yesterday after my prenatal bf class I had a woman tell me that she really
wanted to bf her baby but was told that she could not because of her
"condition".  She has a seizure disorder that presented itself when she was
around 4 yrs. old. She was told that she should not have children, but
found herself pregnant when she went to her OB/GYN to schedule a tubal
ligation.  She is 37 yrs. old and has never been pregnant.  She told me
that her seizures are hard to control, that they mostly occur in her sleep
(in clusters of 10-15 per night), and that she has no prior warning to when
they will occur.  She also said as a young child, she would see aura's of
light and lose her vision for a short time, but did not seize.  The actual
seizures began with the onset of puberty.  She is currently taking the
following medications:  Gabapentin (Neurontin) 1000 mg. 4x day and
Primadone (Mysoline) 500 mg. 2x day. So here are my questions:
1.  I know that phenobarbitol is a metabolized deriviative of Primadone and
could potentially cause problems, could this mom be switched to another
drug (my sister has epilepsy and I remember that when she was bf --they
switched her to Carbamazepine (Tegretol).
2.  If the doctor thinks it is worth the risk to the baby to take these
drugs while pregnant--then why would they be so dangerous after delivery??
3.  Would it be possible to just monitor the baby's plasma levels for
toxicity?
4.  If these drugs are not compatiable with bf, could someone please
suggest alternatives?  I will need hard information since the mom has
stated that the dr. has specifically told her that she cannot bf.
I do have Dr. Hale's new book and Neurontin is stated to be excreted almost
totally renally, but want to know the safety of these drugs together with
the dosages mentioned.
                                  TIA,
                            Pam Holland, BS, IBCLC
                            WIC BF Coord., Savannah, GA