Breastfeeding in Children of Women Taking Antiepileptic Drugs Cognitive Outcomes at Age 6 Years

Children breastfed during maternal AED therapy had higher adjusted IQ at age 6 years by 4 points compared to nonbreastfed children, with no adverse cognitive effects of AED exposure via breast milk.

Effect: improvement; adjusted IQ 4 points higher for breastfed children (regression coefficient 4.1); CI: 95% CI, 0.1 to 8.1

Breastfed children of women on AED therapy showed significantly higher verbal abilities at age 6 years compared to nonbreastfed children, with an adjusted verbal index 4 points higher.

Effect: improvement; adjusted verbal index 4 points higher for breastfed children; CI: 95% CI, 0 to 7

Breastfeeding during maternal AED therapy showed no significant effect on nonverbal abilities, memory, or executive functions at age 6 years.

Effect: null

Fetal valproate exposure was associated with lower IQ at age 6 years compared to other AEDs, with adjusted IQ 7-13 points worse, in a dose-dependent manner.

Effect: adverse; adjusted IQ worse by 7-13 IQ points for valproate compared to other drugs

Periconception folate use was associated with higher child IQ at age 6 years, with adjusted IQ 6 points higher in the folate group compared to those without periconception folate.

Effect: improvement; adjusted IQ 6 points higher for folate group (regression coefficient 5.7); CI: 95% CI, 1.7 to 9.7