Potential Dangers of Topamax While Breastfeeding

According to the FDA, topiramate (Topamax) can pass into breast milk and may harm a nursing baby. For this reason, you should never take Topamax without telling your healthcare provider that you are breastfeeding your child. Topamax is passed through breast milk in relatively low amounts and in a few small studies involving Topamax use while breastfeeding, no problems were seen in the infant. However, children as young as two years old who take Topamax may experience side effects like confusion, aggressiveness, drowsiness, infections, weight loss and appetite loss. It is possible that these side effects may also present in children who are exposed to Topamax through breast milk. If your physician recommends taking Topamax while breastfeeding, you should be aware of these side effects and watch out for them in your infant. Because of the side effects that may affect a nursing infant exposed to Topamax through breast milk, physicians are advised to consider all risks and benefits before recommending Topamax to women who are breastfeeding. If you are taking Topamax, talk to your physician about the best way to breastfeed your baby; in most cases, mothers who require Topamax treatment are encouraged to bottle feed their infants.

Topamax Use During Pregnancy

While the potentially harmful side effects in children of Topamax use while breastfeeding is largely unknown, there is a large body of research which has examined the adverse effects of fetal exposure to Topamax during pregnancy. After reviewing the results of this research, the FDA has elevated the pregnancy category of Topamax from C to D, signifying that there is positive human evidence illustrating the drug’s potential to cause significant, unreasonable harm to a fetus when taken during pregnancy. The FDA has also advised healthcare providers to avoid prescribing Topamax to pregnant women unless the possible benefits of the treatment justify the potential side effect risks to the fetus including the development of cleft palate, cleft lip, and hypospadias genital defects.

As a spokesperson for the American Academy of Neurology states, Topamax may no longer be considered an appropriate treatment for pregnant women suffering from migraine headaches. However, the tolerance for risk for migraine headache patients is different for epilepsy patients. Epileptic seizures can cause serious injury to both mother and child, making it necessary for pregnant women to control these seizures with Topamax, despite the potential for the drug to cause serious birth defects including cleft lip in infants. Although migraines can be a debilitating condition for the mother, they typically do not pose a danger to the fetus. Therefore, for women who are pregnant or breastfeeding, Topamax use may cause side effects that are significant enough to outweigh even the benefits of the treatment, especially for women taking the drug to prevent migraines.