Divalproex Sodium Pellet while Breastfeeding

Is Divalproex Sodium Pellet usage safe while breastfeeding? If a lactating mother is using it can there be any effect on growth or development of infant?

Valproic acid while Breastfeeding

CAS Number: 99-66-1

It is excreted in breast milk in clinically non-significant amount without problems in the short or long term in infants whose mothers were treated. Plasma levels of these infants were undetectable or very low. Cognitive development did not suffer any alteration. An infant was presented with thrombocytopenic purpura and anemia who recovered after removing valproate in the mother. However, doubts were raised on whether it was instead a post-viral reaction that led to idiopathic thrombocytopenic purpura. The administration of valproic acid does not affect prolactin levels. The American Academy of Pediatrics rates it as usual compatible with breastfeeding medication.WHO List of Essential Medicines 2002: compatible with breastfeeding.

Valproic acid while Breastfeeding

CAS Number: 99-66-1

Breastfeeding during valproic acid monotherapy does not appear to adversely affect infant growth or development, and breastfed infants had higher IQs and enhanced verbal abilities than nonbreastfed infants at 6 years of age in one study.[1] If valproic acid is required by the mother, it is not necessarily a reason to discontinue breastfeeding. Because of the low levels of valproic acid in breastmilk and infant serum, no definite adverse reactions to valproic acid during breastfeeding have been reported. Theoretically, breastfed infants are at risk for valproic acid-induced hepatotoxicity, so infants should be monitored for jaundice and other signs of liver damage during maternal therapy. A questionable case of thrombocytopenia has been reported, so monitor the infant for unusual bruising or bleeding. One author recommends monitoring infant serum valproate levels, platelets and liver enzymes during therapy.[1] Combination therapy with sedating anticonvulsants or psychotropics may result in infant sedation or withdrawal reactions.

I already used Divalproex Sodium Pellet and meanwhile I breastfed my baby should I be concerned?

I am nursing mother and my doctor has suggested me to use Divalproex Sodium Pellet, is it safe?

If I am using Divalproex Sodium Pellet, will my baby need extra monitoring?

Who can I talk to if I have questions about usage of Divalproex Sodium Pellet in breastfeeding?