Is Gabapentin Safe in Breastfeeding

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

Antiepileptic drug that is also used in the treatment of neuropathic pain and Restless Leg Syndrome. It is excreted into breast milk in clinically non-significant amount. No problem was observed in infants whose mothers were on this medication.Plasma levels in those infants were undetectable or very low.

Limited information indicates that maternal doses of gabapentin up to 2.1 grams daily produce relatively low levels in infant serum. Monitor the infant for drowsiness, adequate weight gain, and developmental milestones, especially in younger, exclusively breastfed infants and when using combinations of anticonvulsant or psychotropic drugs. A single oral dose of either 300 mg or 600 mg given to the mother before cesarean section appeared to have no effect on breastfeeding initiation.[1] An expert consensus guideline indicates that gabapentin is an acceptable choice for refractory restless leg syndrome during lactation.[2]

Three infants who were 2 to 3 weeks of age and one who was 14 weeks of age were breastfed during maternal use of gabapentin in an average daily dosages of 1575 mg (range 600 mg to 2.1 grams daily). One infant's mother was also taking topiramate and lorazepam and another infant's mother was taking clonazepam. No adverse effects were noted in any of the infants.[3] A follow-up publication by the same authors found no adverse reactions among 3 additional breastfed infants whose mothers were taking gabapentin during pregnancy and lactation.[4]< An exclusively breastfed 5-day-old infant whose mother was taking gabapentin 1.2 grams and levetiracetam 2.5 grams daily during pregnancy and lactation appeared healthy to the investigators throughout the 6- to 8-week study period.[6] An infant whose mother was taking gabapentin 36.7 mg/kg daily breastfed her infant 6 to 7 times daily for most of the first 1.6 months of life with some additional artificial feeding at night. The mother was also taking amitriptyline 2.5 mg daily. At 1.6 months of age, the infant was found to be healthy with a weight between the 10th and 25th percentiles, having been at the 50th percentile at birth. His age on the Denver developmental test was the same as his chronological age.[5]