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[2] Based on breast milk concentrations from 3 women taking 150 to 200 mg topiramate daily, it was estimated that a breastfed infant (assuming a milk intake of 150 mL/kg/day) would receive approximately 0.1 to 0.7 mg/kg/day or 3% to 23% of the maternal weight-adjusted dose

Still, Srivastava cautions against treating those averages as guarantees

however, there is limited information in women with obesity or overweight

Risk mitigation strategies include a 24-hour clear liquid diet before surgery and enhanced airway protection measures

Eating enough protein and staying healthy supports this

Weekly weigh-ins, appetite ratings, and progress photos create a data trail that can reveal potency issues before they become obvious