Weighing the pros and cons of breastfeeding Breastfeeding can strengthen the newborn’s resistance and prevent diseases of the digestive and respiratory tracts and other organs. The milk concentration of AEDs is inversely proportional to their plasma protein binding rate in the mother, and the current ratio of milk concentration to maternal plasma concentration (M/S) for AEDs is 5%-10% for valproate, 36%-40% for carbamazepine, 6%-20% for phenytoin sodium, 40% for phenobarbital, 71% for paroxetine, and 90% for ethosuximide. 40%, paroxetine 71%, and ethosuximide 90%. The M/S of the new generation AEDs are all higher, with oxcarbazepine at 50%-64%, lamotrigine at 60%, topiramate at 66%-110%, and levetiracetam at 100%-300% . Although breast milk concentrations may be lower in some AEDs, the reduced serum protein binding and slowed hepatic metabolism rates in neonates maintain serum drug levels in the therapeutic concentration range in all neonates. When breastfeeding female patients with epilepsy treated with phenobarbital and paroxetine, the newborn often shows sedative effects and feeding difficulties, and breastfeeding should be interrupted, but the newborn should be observed for withdrawal symptoms. Hematologic and liver function abnormalities in breastfed infants have been reported less frequently. Overall, breastfeeding is not an absolute contraindication for newborns of women with epilepsy. When deciding whether to breastfeed a newborn, various factors should be considered, such as the desire to breastfeed, the type, amount, and dose of AEDs, and the condition of the newborn, to weigh the pros and cons of breastfeeding comprehensively.