Is Ethosuximide Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Ethosuximide? Is Ethosuximide safe for nursing mother and child? Does Ethosuximide extracts into breast milk? Does Ethosuximide has any long term or short term side effects on infants? Can Ethosuximide influence milk supply or can Ethosuximide decrease milk supply in lactating mothers?

• DrLact safety Score for Ethosuximide is 5 out of 8 which is considered Unsafe as per our analyses.
• A safety Score of 5 indicates that usage of Ethosuximide may cause serious side effects in breastfed baby.
• Our study of different scientific research indicates that Ethosuximide may cause moderate to high side effects or may affect milk supply in lactating mother.
• Our suggestion is to use safer alternate options rather than using Ethosuximide .
• It is recommended to evaluate the advantage of not breastfeeding while using Ethosuximide Vs not using Ethosuximide And continue breastfeeding.
• While using Ethosuximide Its must to monitor child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
• Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Some cases of sedation and hyperexcitability and weak suction have been described. It have been reported, though, one case of two months lasting irritability and insomnia in an infant born to a mother who had taken the drug during pregnancy but did not breastfeed the child. If a pregnant woman has not been switched to other anti-convulsivant drug it would be a better option for the mother to keep-on suckling her child and follow-up the infant closely.

Average ethosuximide dosages of 50 to 60% of the maternal weight-adjusted dosage are excreted in human milk and infant plasma levels of 25 to 30% of maternal levels are common. Although no adverse effects attributable solely to ethosuximide in breastmilk have been reported, monitor the infant for drowsiness, adequate weight gain, and developmental milestones, especially in younger, exclusively breastfed infants and when using combinations of anticonvulsants. Measurement of an infant serum level might help rule out toxicity if there is a concern.

An infant whose mother was taking ethosuximide 250 mg daily began exclusive breastfeeding on day 2 postpartum and continued through 4.5 months of observation. The infant developed normally during this time and had no signs of an adverse reaction.[3]Sedation, poor sucking and poor weight gain during the first 4 weeks of life occurred in a breastfed newborn whose mother was taking ethosuximide.[4] The reaction was possibly caused by ethosuximide in breastmilk; however, the mother was also taking primidone and valproic acid. Three fully breastfed infants and a mostly formula-fed whose mothers were taking ethosuximide had no adverse reactions observed during the first 1.5 to 4.5 months of life.[5]