CHICAGO -- April 22, 2008 -- A first of its kind study finds breastfeeding while taking certain seizure medications does not appear to harm a child's cognitive development. The research was presented at the 60th Anniversary Annual Meeting of the American Academy of Neurology held in Chicago, Illinois, from April 12 to 19, 2008.
"Our early findings show breastfeeding during antiepilepsy drug treatment does not appear to have a negative impact on a child's cognitive abilities," said study author Kimford Meador, MD, Melvin Greer Professor of Neurology, Department of Neurology, University of Florida, Gainesville, Florida, and Fellow of the American Academy of Neurology. "However, more research is needed to confirm our findings, and women should use caution due to the limitations of our study."
Researchers tested the cognitive development of 2-year-old children (N = 187) whose mothers were taking the epilepsy drugs lamotrigine, carbamazepine, phenytoin, or valproate. Forty-one percent of the children were breastfed.
The study found that breastfed children had higher cognitive test scores than those who were not breastfed, and this trend was consistent for each antiepilepsy drug. The children who were breastfed received an average test score of 98.1 compared with a score of 89.5 for the children not breastfed. However, the results were not significant after adjusting for the mother's IQ. Thus, it appears that the higher scores in children who were breastfed were due to the fact that their mothers had higher IQs.
Dr. Meador says animal studies have shown that some antiepilepsy drugs, but not all, can cause cells to die in immature brains, but this effect can be blocked by the protective effects of beta-estradiol, the mother's sex hormone. "Since the potential protective effects of beta-estradiol in utero are absent after birth, concern was raised that breastfeeding by women taking antiepilepsy drugs may increase the risk of antiepilepsy drug-induced cell death and result in reduced cognitive outcomes in children."
Dr. Meador says additional research on the effects of breastfeeding should be extended to other antiepilepsy drugs and mothers who use more than one antiepilepsy medication.
The study is part of an ongoing trial of the long-term effects of in utero antiepilepsy drug exposure on children's cognition. Women with epilepsy who were taking antiepilepsy drugs were enrolled in the study during pregnancy. Ultimately, the study will examine the effects of in utero antiepilepsy drug exposure on children at 6 years old.
SOURCE: American Academy of Neurology
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