Effects of breastfeeding in children of women taking antiepileptic drugs

K. J. Meador; G. A. Baker; N. Browning; J. Clayton-Smith; D. T. Combs-Cantrell; M. Cohen; L. A. Kalayjian; A. Kanner; J. D. Liporace; P. B. Pennell; M. Privitera; D. W. Loring

doi:10.1212/WNL.0b013e3181ffe4a9

Effects of breastfeeding in children of women taking antiepileptic drugs

K. J. Meador, G. A. Baker, N. Browning, J. Clayton-Smith, D. T. Combs-Cantrell, M. Cohen, L. A. Kalayjian, A. Kanner, J. D. Liporace, P. B. Pennell, M. Privitera, D. W. Loring

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Abstract

Background: Breastfeeding is known to have beneficial effects, but there is concern that breastfeeding during antiepileptic drug (AED) therapy may be harmful to cognitive development. Animal and human studies have demonstrated that some AEDs can adversely affect the immature brain. However, no investigation has examined effects of breastfeeding during AED therapy on subsequent cognitive abilities in children. Methods: The Neurodevelopmental Effects of Antiepileptic Drugs Study is an ongoing prospective multicenter observational investigation of long-term effects of in utero AED exposure on cognition. Between 1999 and 2004, we enrolled pregnant women with epilepsy who were taking a single AED (carbamazepine, lamotrigine, phenytoin, or valproate). We recently reported on differential AED effects on age 3 year cognitive outcomes. In this report, we focus on the effects of breastfeeding during AED therapy on age 3 cognitive outcomes in 199 children. Results: A total of 42% of children were breastfed. IQs for breastfed children did not differ from nonbreastfed children for all AEDs combined and for each of the 4 individual AED groups. Mean adjusted IQ scores (95% confidence intervals) across all AEDs were breastfed = 99 (96-103) and nonbreastfed = 98 (95-101). Power was 95% to detect a half SD IQ effect in the combined AED analysis, but was inadequate within groups. Conclusions: This preliminary analysis fails to demonstrate deleterious effects of breastfeeding during AED therapy on cognitive outcomes in children previously exposed in utero. However, caution is advised due to study limitations. Additional research is needed to confirm this observation and extend investigations to other AEDs and polytherapy. Copyright © 2010 by AAN Enterprises, Inc.

Original language	English
Pages (from-to)	1954-1960
Number of pages	6
Journal	Neurology
Volume	75
Issue number	22
DOIs	https://doi.org/10.1212/WNL.0b013e3181ffe4a9
Publication status	Published - 30 Nov 2010

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@article{d40c34638e1e4b909fd83c0a18a2043c,

title = "Effects of breastfeeding in children of women taking antiepileptic drugs",

abstract = "Background: Breastfeeding is known to have beneficial effects, but there is concern that breastfeeding during antiepileptic drug (AED) therapy may be harmful to cognitive development. Animal and human studies have demonstrated that some AEDs can adversely affect the immature brain. However, no investigation has examined effects of breastfeeding during AED therapy on subsequent cognitive abilities in children. Methods: The Neurodevelopmental Effects of Antiepileptic Drugs Study is an ongoing prospective multicenter observational investigation of long-term effects of in utero AED exposure on cognition. Between 1999 and 2004, we enrolled pregnant women with epilepsy who were taking a single AED (carbamazepine, lamotrigine, phenytoin, or valproate). We recently reported on differential AED effects on age 3 year cognitive outcomes. In this report, we focus on the effects of breastfeeding during AED therapy on age 3 cognitive outcomes in 199 children. Results: A total of 42% of children were breastfed. IQs for breastfed children did not differ from nonbreastfed children for all AEDs combined and for each of the 4 individual AED groups. Mean adjusted IQ scores (95% confidence intervals) across all AEDs were breastfed = 99 (96-103) and nonbreastfed = 98 (95-101). Power was 95% to detect a half SD IQ effect in the combined AED analysis, but was inadequate within groups. Conclusions: This preliminary analysis fails to demonstrate deleterious effects of breastfeeding during AED therapy on cognitive outcomes in children previously exposed in utero. However, caution is advised due to study limitations. Additional research is needed to confirm this observation and extend investigations to other AEDs and polytherapy. Copyright {\textcopyright} 2010 by AAN Enterprises, Inc.",

author = "Meador, {K. J.} and Baker, {G. A.} and N. Browning and J. Clayton-Smith and Combs-Cantrell, {D. T.} and M. Cohen and Kalayjian, {L. A.} and A. Kanner and Liporace, {J. D.} and Pennell, {P. B.} and M. Privitera and Loring, {D. W.}",

year = "2010",

month = nov,

day = "30",

doi = "10.1212/WNL.0b013e3181ffe4a9",

language = "English",

volume = "75",

pages = "1954--1960",

journal = "Neurology",

issn = "0028-3878",

publisher = "Lippincott Williams & Wilkins",

number = "22",

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TY - JOUR

T1 - Effects of breastfeeding in children of women taking antiepileptic drugs

AU - Meador, K. J.

AU - Baker, G. A.

AU - Browning, N.

AU - Clayton-Smith, J.

AU - Combs-Cantrell, D. T.

AU - Cohen, M.

AU - Kalayjian, L. A.

AU - Kanner, A.

AU - Liporace, J. D.

AU - Pennell, P. B.

AU - Privitera, M.

AU - Loring, D. W.

PY - 2010/11/30

Y1 - 2010/11/30

N2 - Background: Breastfeeding is known to have beneficial effects, but there is concern that breastfeeding during antiepileptic drug (AED) therapy may be harmful to cognitive development. Animal and human studies have demonstrated that some AEDs can adversely affect the immature brain. However, no investigation has examined effects of breastfeeding during AED therapy on subsequent cognitive abilities in children. Methods: The Neurodevelopmental Effects of Antiepileptic Drugs Study is an ongoing prospective multicenter observational investigation of long-term effects of in utero AED exposure on cognition. Between 1999 and 2004, we enrolled pregnant women with epilepsy who were taking a single AED (carbamazepine, lamotrigine, phenytoin, or valproate). We recently reported on differential AED effects on age 3 year cognitive outcomes. In this report, we focus on the effects of breastfeeding during AED therapy on age 3 cognitive outcomes in 199 children. Results: A total of 42% of children were breastfed. IQs for breastfed children did not differ from nonbreastfed children for all AEDs combined and for each of the 4 individual AED groups. Mean adjusted IQ scores (95% confidence intervals) across all AEDs were breastfed = 99 (96-103) and nonbreastfed = 98 (95-101). Power was 95% to detect a half SD IQ effect in the combined AED analysis, but was inadequate within groups. Conclusions: This preliminary analysis fails to demonstrate deleterious effects of breastfeeding during AED therapy on cognitive outcomes in children previously exposed in utero. However, caution is advised due to study limitations. Additional research is needed to confirm this observation and extend investigations to other AEDs and polytherapy. Copyright © 2010 by AAN Enterprises, Inc.

AB - Background: Breastfeeding is known to have beneficial effects, but there is concern that breastfeeding during antiepileptic drug (AED) therapy may be harmful to cognitive development. Animal and human studies have demonstrated that some AEDs can adversely affect the immature brain. However, no investigation has examined effects of breastfeeding during AED therapy on subsequent cognitive abilities in children. Methods: The Neurodevelopmental Effects of Antiepileptic Drugs Study is an ongoing prospective multicenter observational investigation of long-term effects of in utero AED exposure on cognition. Between 1999 and 2004, we enrolled pregnant women with epilepsy who were taking a single AED (carbamazepine, lamotrigine, phenytoin, or valproate). We recently reported on differential AED effects on age 3 year cognitive outcomes. In this report, we focus on the effects of breastfeeding during AED therapy on age 3 cognitive outcomes in 199 children. Results: A total of 42% of children were breastfed. IQs for breastfed children did not differ from nonbreastfed children for all AEDs combined and for each of the 4 individual AED groups. Mean adjusted IQ scores (95% confidence intervals) across all AEDs were breastfed = 99 (96-103) and nonbreastfed = 98 (95-101). Power was 95% to detect a half SD IQ effect in the combined AED analysis, but was inadequate within groups. Conclusions: This preliminary analysis fails to demonstrate deleterious effects of breastfeeding during AED therapy on cognitive outcomes in children previously exposed in utero. However, caution is advised due to study limitations. Additional research is needed to confirm this observation and extend investigations to other AEDs and polytherapy. Copyright © 2010 by AAN Enterprises, Inc.

U2 - 10.1212/WNL.0b013e3181ffe4a9

DO - 10.1212/WNL.0b013e3181ffe4a9

M3 - Article

SN - 0028-3878

VL - 75

SP - 1954

EP - 1960

JO - Neurology

JF - Neurology

IS - 22

ER -

Effects of breastfeeding in children of women taking antiepileptic drugs

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