1. We use phenytoin in small babies.
2. Here's the concluding sentence in Hale's book "all of the current studies
indicate rather low levels of phenytoin in breastmilk and minimal plasma
levels in breastfeeding infants".

The monkey wrench is that Hale starts out by saying "The effect on the
infant is generally considered minimal if the levels in the maternal
circulation are kept in low-normal range (10 micrograms/ml)".  I'm not sure
why this is there, since there is no evidence the baby gets much.

Jack Newman, MD, FRCPC