title: Managing Migraine During Pregnancy and Lactation.
abstract: While over half of women with migraine report improvement during pregnancy, having a history of migraine may increase the chance of negative health outcomes. The state of pregnancy increases the risk of several dangerous secondary headache disorders, especially those associated with hypertensive disorders of pregnancy, and providers need to know the red flags to diagnose and treat emergently. Non-pharmacological migraine treatments can be instituted in advance of pregnancy as many are considered the safest options during pregnancy, but understanding the safety of medications and dietary supplements ensures appropriate care for the refractory migraine patient. New controversy exists over the safety of several historically routine and safe migraine treatment options in pregnancy, such as magnesium, acetaminophen, ondansetron, and butalbital. While it is not clear if breastfeeding decreases the postpartum recurrence of migraine, understanding safe treatment options during lactation can allow women to continue breastfeeding while achieving migraine relief.
authors.affiliation: Department of Neurology, Wake Forest Baptist Health, Medical Center Blvd, Winston-Salem, NC, 27157, USA. rewells@wakehealth.edu.
authors.forename: Rebecca Erwin
authors.initials: RE
authors.lastname: Wells
authors.affiliation: Department of Anesthesiology, Wake Forest Baptist Health, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
authors.forename: Dana P
authors.initials: DP
authors.lastname: Turner
authors.affiliation: Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Neurology, Wake Forest Baptist Health, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Bishop
authors.affiliation: Department of Neurology, Wake Forest Baptist Health, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Strauss
mesh_terms: D000818:Animals; D005260:Female; D051271:Headache Disorders, Secondary; D006801:Humans; D006973:Hypertension; D007774:Lactation; D008881:Migraine Disorders / Q000209:etiology*; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications
keywords: Headache; Lactation; Migraine; Pregnancy