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Vigabatrin is an analogue of gamma-aminobutyric acid (GABA) that acts as an irreversible inhibitor of GABA transaminase. It is used as an adjunctive antiepileptic drug in patients with refractory partial epilepsy and as monotherapy for infantile spasms in infants aged 1 month to 2 years. It is administered orally in one or two daily doses.
It is excreted in breast milk in clinically insignificant amounts (Tran 1998); the dose that the infant may receive through breast milk is more than 100 times lower than the usual neonatal dose (50-150 mg/kg/day).
Furthermore, its low oral bioavailability hinders its passage into the infant's plasma from ingested breast milk, except in premature infants and the immediate neonatal period, when there may be greater intestinal permeability.
Expert authors do not consider this drug incompatible with breastfeeding. (Hale, LactMed, Crettenand 2018, Veiby 2015, Davanzo 2013, Rubin 2004, Bar-Oz 2000)