Modern migraine treatments during Breastfeeding

[MaryMary]

Hi-
What migraine treatments (abortive and preventative) are the safest and/or most well understood during breastfeeding?

I will soon be post-partum with my second child and plan to exclusively breastfeed. I, like many other chronic migraine suffers, experienced migraine symptom relief during pregnancy. But I know from my experience with my first child that the migraines will soon return with avengence and I'm interested in being pro-active this time.
I've been looking through the forum but haven't found much information on some of the more recent CGRP medications.
For abortive medications, previous older posts seemed to highly recommend intranasal Sumatriptan, since it works quickly, is well understood, and has a short half-life. Is that still the best option or are any of the CGRP inhibitors something to consider during breastfeeding?
For preventative medications, what are the safest medications worth considering?
Thanks,
MaryMary

[admin]

MaryMary:

I've got some really good news for you. My InfantRisk center just finished a clinical trial with rimagepant (CRGP inhibitor) in 12 breastfeeding mothers. While I can't tell you any exact details yet (its in publication right now), I can tell you that milk levels were really really low. I was quite excited about this data.

So I'd talk with you physician about this drug. They can actually prescribe it in tablet form. There are now studies of its use 'chronically'.

Tom Hale Ph.D.