This mom should immediately seek a second opinion. It is very, very 
unwise to mess with a pregnant mother's seizure medication, as seizures 
can have very significant adverse effects on the fetus (prolonged 
hypoxia, well beyond the duration of the seizure, for one).
Dr. Hale still has topamax classified as L3, and writes that the 
infant's plasma level is lower than the mothers, and "the risk of using 
this product in breastfeeding mothers is probably acceptable".

If mom is using this medication for bipolar disorder, she similarly 
should not have her medication changed at such a vulnerable time.
Catherine Watson Genna, IBCLC  NYC

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