Parenting Concerns for the Mother with Epilepsy

I am pregnant and I'm worried about my seizure disorder. How can I keep my child safe and healthy?

Epilepsy affects people in different ways. Some parents will need to make several changes in their lives to provide a safe environment for the baby. Others will need to make very few changes. It is helpful to think about your personal seizure pattern and the specific risks or problems that you might have. Then choose lifestyle adaptations that will provide solutions for you. Every prospective parent has to think through issues like these. There may be additional factors for people with epilepsy to consider.

During pregnancy and after delivery, the best thing you can do for your baby is to take good care of yourself. Get enough sleep, eat well, exercise regularly, and take your prescribed seizure medication. Keep in close contact with your neurologist and your gynecologist/obstetrician, and talk with them about necessary adjustments in your lifestyle.

How do I know if I need to be concerned about my seizure pattern?

It depends on your seizure type, and the frequency of your seizures. It may be helpful to ask yourself, "Do I fall with my seizures? Do I lose consciousness? Do I get a warning?" Some women with epilepsy may have changes in their seizures while they are pregnant. During pregnancy, concentrations of your antiepileptic drug (AED) may change or decrease, putting you at greater risk for seizures. After delivery, medication levels in your bloodstream tend to rise, increasing the possibility of side effects. These factors may make it necessary for your physician to check medication blood levels more frequently in the first few months after delivery.

I want to breast-feed my baby. Will that be safe?

For most women with epilepsy, breast-feeding is a safe option. All seizure medications will be found in small amounts in breast milk, but this usually does not affect the baby. Some women who are taking phenobarbital (Luminal) or primidone (Mysoline) may notice that their babies are too sleepy or irritable. If this is a significant problem, ask your physician or the pediatrician about supplemental bottle feedings. Breast-feeding may create more demands on you, particularly at night, with loss of sleep. Explore all your options including bottle-feeding, or a combination of breast and bottle, to find what works best for you.

My mother has offered to stay with us for a while, but I don't want to be a burden to my family. Can I manage alone?

The birth of a baby is a monumental event for any woman! It changes your life, and the first few weeks can seem overwhelming. Every mother has disturbed sleep, extra work and hormonal changes -- and for a woman with epilepsy these factors can increase the risk of seizures. So it makes sense to include other family members or friends in the care of your baby. That will give you a chance to rest. The best way to take care of your baby is to take good care of yourself.

I often fall during my seizures. What if I have a seizure while I'm feeding my baby?

Feed your baby in a comfortable chair, or on your bed with good back support. Or feed the baby while seated on a pad on the floor. Keep the baby next to your bed at night, and feed her in bed with you. If you are using a bottle, have a family member help you -- one of you can hold the baby and the other can fix the bottle. If you are alone, don't carry the baby to the kitchen -- leave your baby in the crib while you prepare the bottle and bring it back. When your baby is older, always strap her into a high chair or infant seat for feedings.

What is the best way to diaper my baby?

The safest way to dress or diaper a newborn is to sit on the floor with a pad. A changing table is not as safe, but if you use one, be sure to strap your baby on securely. Keep diapers and infant care supplies on every level of the house to limit stair climbing.

How can I safely give my baby a bath?

If you are using a tub, it makes sense to have another person with you when you bathe your baby. When you're alone, give sponge baths on the floor, with a separate bowl of water.

I want to have my baby with me, but I often have seizures. What should I do?

Use an "umbrella stroller" in the house, instead of carrying your baby. Keep toys and baby supplies in different areas of the house so they are there when you need them. Use a playpen or other enclosed area to provide a safe place for your baby to sleep and play when you are caring for him by yourself.

Are there household chores that might be dangerous?

Yes. Avoid holding your baby while you are cooking. Delay ironing or other potentially dangerous activities until another person is there.

Once my baby starts to walk, how can I keep her safe if I have a seizure?

There are many child care books that give parents advice about "child-proofing" a home. It helps to get down on the floor and look at the world like your toddler does. Added factors you need to consider are what happens when you have a seizure, and how often you have seizures. Think about what might happen if you were confused or lost consciousness, even briefly.

Keep outside doors locked, and close inside doors to rooms where your toddler could hurt herself (kitchen or bathroom) if you lose consciousness during a seizure. Use a safety gate across stairs, cover electrical outlets, and get child-proof latches for drawers and cabinets (especially ones where you store medication, sharp objects, or other dangerous substances). Consider an enclosed play area, in the house and outside, where your child can be safe if you have a seizure while you are alone with her. When your child is ready to be toilet-trained, try a child-size "potty chair," not a booster seat on the toilet. Whenever your child is in the bathroom, be sure the toilet is covered and cabinets and drawers are locked.

How can I keep my toddler from walking away if I have a seizure?

If you have seizures that make you confused or unaware, consider using a stroller, a child safety harness, or a wrist bungee cord to keep your child nearby, both at home and when you are outside. This may reduce the risk of your child wandering away if you have a seizure and no one else is there.

How should I tell my child about my epilepsy?

Explain your condition in simple words that your child can understand. Let him know that between seizures you are healthy and normal. As your child gets older, it may help everyone feel more secure to have "seizure drills,"-- to practice seizure first aid and how to call for help. If your child is fearful about seizures, talk about it and answer questions honestly. Ask your physician or nurse for more information.