{
  "abstract": "Importance: Concerns regarding infant exposure to antiseizure medications (ASMs) via breast milk frequently discourage breastfeeding in women with epilepsy (WWE). Longitudinal neurodevelopmental data for breastfeeding while taking contemporary ASM regimens are essential for evidence-based management.\n\nObjective: To evaluate the association between breastfeeding duration and neurodevelopmental outcomes at age 6 years in children exposed to contemporary ASM regimens.\n\nDesign, Setting, and Participants: The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study is a prospective, multicenter, cohort study. Pregnant WWE and healthy pregnant women were enrolled from December 2012 to October 2016, with children followed up to age 6 years. Children’s outcomes were analyzed between January 2023 and December 2024.\n\nExposures: Breastfeeding duration (none, <6 months, ≥6 months) and children’s exposure to contemporary ASMs (primarily levetiracetam and lamotrigine).\n\nMain Outcomes and Measures: The primary outcomes at child age 6 years included verbal language (Verbal Index Score) and adaptive behavior (General Adaptive Composite score in Adaptive Behavior Assessment System Scale).\n\nResults: A total of 273 children of WWE (median [range] maternal age, 31.0 [19.0-46.0] years; 127 [46.5%] male) and 84 children of healthy women (median maternal age, 31.0 [15.0-38.0] years; 47 [56.0%] male) were included, with 262 children of WWE and 80 children of healthy women in the language outcome sample and 261 children of WWE and 83 children of healthy women in the behavioral outcome set. Adjusted mean (SD) verbal language (107.93 [0.71] vs 107.18 [1.40]; difference, 0.75; 95% CI, −2.40 to 3.89; P = .64) and adaptive behavior (102.91 [0.75] vs 102.14 [1.46]; difference, 0.78; 95% CI, −2.52 to 4.07; P = .64) outcomes did not significantly differ between groups. Within the WWE cohort, breastfeeding for 6 months or longer was significantly associated with higher adaptive behavioral scores compared with no breastfeeding (estimate, 4.68; 95% CI, 1.34 to 8.03; P = .01), driven by practical and conceptual subdomains; whereas shorter durations (<6 months) did not differ. Neurodevelopmental outcomes were comparable within each specific ASM regimen—including levetiracetam, lamotrigine, other monotherapy, and polytherapy—regardless of breastfeeding duration. Notably, the benefit associated with breastfeeding for 6 months or longer remained significant in the pooled monotherapy group (difference, 5.88; 95% CI, 2.21 to 9.55; P = .001) but not in the polytherapy group.\n\nConclusions and Relevance: In this cohort study of children born to WWE, breastfeeding while taking contemporary ASM regimens was not associated with adverse neurodevelopmental outcomes at age 6 years. The observed improved adaptive behavioral outcome supports clinical recommendations for extended breastfeeding (≥6 months) in WWE.",
  "abstract_shown": true,
  "affiliations": [
    "Stanford University, Palo Alto, California",
    "Emory University School of Medicine, Atlanta, Georgia",
    "Pediatric Neuropsychology International, Augusta, Georgia",
    "Feinberg School of Medicine, Northwestern University, Chicago, Illinois",
    "University of Minnesota, Minneapolis",
    "The Emmes Company, Rockville, Maryland",
    "University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania",
    "for the MONEAD Investigator Group"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 139,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yi Li"
    },
    {
      "affs": [
        1
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      "name": "David W. Loring"
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    {
      "affs": [
        2
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      "name": "Morris J. Cohen"
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    {
      "affs": [
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      "name": "Elizabeth E. Gerard"
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    {
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      "name": "Angela K. Birnbaum"
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      "name": "Abigail G. Matthews"
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    {
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      "name": "Page B. Pennell"
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    {
      "affs": [
        0
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      "name": "Kimford J. Meador"
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    {
      "name": "MONEAD Investigator Group"
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        7
      ],
      "name": "Maurice Druzin"
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        7
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      "name": "Richard Finnell"
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      "name": "Zachary Stowe"
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      "name": "Linda Van Marter"
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      "name": "Peter Wells"
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      "name": "Mark Yerby"
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      "name": "Ryan May"
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        7
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      "name": "Dominic Ippolito"
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        7
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      "name": "Lisa Davis"
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      "name": "Nilay Shah"
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      "name": "Brenda Leung"
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    {
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        7
      ],
      "name": "Mark Friedman"
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    {
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        7
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      "name": "Traci Sheer"
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    {
      "affs": [
        7
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      "name": "Yue Wang"
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        7
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      "name": "Suzanne Strickland"
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        7
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      "name": "Erin Latif"
    },
    {
      "affs": [
        7
      ],
      "name": "Yong Park"
    },
    {
      "affs": [
        7
      ],
      "name": "Delmaris Acosta-Cotte"
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    {
      "affs": [
        7
      ],
      "name": "Patty Ray"
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    {
      "affs": [
        7
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      "name": "Kirsten Cleary"
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    {
      "affs": [
        7
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      "name": "Joyce Echo"
    },
    {
      "affs": [
        7
      ],
      "name": "Annette Zygmunt"
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    {
      "affs": [
        7
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      "name": "Camilla Casadei"
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    {
      "affs": [
        7
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      "name": "Mary Dolan"
    },
    {
      "affs": [
        7
      ],
      "name": "Kim Ono"
    },
    {
      "affs": [
        7
      ],
      "name": "Donald Bearden"
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    {
      "affs": [
        7
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      "name": "Christine Ghilian"
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    {
      "affs": [
        7
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      "name": "Diane Teagarden"
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    {
      "affs": [
        7
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      "name": "Melanee Newman"
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    {
      "affs": [
        7
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      "name": "Paul McCabe"
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    {
      "affs": [
        7
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      "name": "Michael Paglia"
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    {
      "affs": [
        7
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      "name": "Rosemarie Delucca"
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    {
      "affs": [
        7
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      "name": "Kristina Blessing"
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    {
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      "name": "Katrina Boyer"
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      "name": "Ellen Hanson"
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      "name": "Amy Young"
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      "name": "Jolie Strauss"
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      "name": "Hayley Madeiros"
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      "name": "Li Chen"
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      "name": "Stephanie Allien"
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      "name": "Taylor Weinau"
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      "name": "Melanie Choe"
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      "name": "Gregory L. Barkley"
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      "name": "Marianna Spanaki-Varelas"
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  "bibtex": "https://research.draconitic.com/paper/6wyvp9mps2gva.bib",
  "cited_by": 0,
  "doi": "10.1001/jamanetworkopen.2026.37040",
  "fulltext_url": null,
  "id": "6wyvp9mps2gva",
  "issns": [
    "2574-3805"
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  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2735|Pharmacological Effects and Toxicity Studies"
    ]
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  "openalex": "W7214985070",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-30",
  "publisher": "American Medical Association (AMA)",
  "ris": "https://research.draconitic.com/paper/6wyvp9mps2gva.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:46Z",
      "native_id": "10.1001/jamanetworkopen.2026.37040",
      "source": "crossref",
      "url": "https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2854645"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2735|Pharmacological Effects and Toxicity Studies",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Breastfeeding and Neurodevelopmental Outcomes in Children of Women Taking Antiseizure Medications",
  "title_text": "Breastfeeding and Neurodevelopmental Outcomes in Children of Women Taking Antiseizure Medications",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:46Z",
  "url": "https://research.draconitic.com/paper/6wyvp9mps2gva",
  "venue": "JAMA Network Open",
  "versions": []
}