Despite the unquestionable benefits of breastfeeding for both the child and the mother, many women on antiepileptic therapy are concerned about their child’s safety and refrain from breastfeeding. This decision is sometimes also influenced by doctors, who base their knowledge regarding the safety of pharmacotherapy during breastfeeding on information provided by manufacturers in the summary of product characteristics. Meanwhile, most agents fail to reach breast milk levels high enough to cause significant clinical levels in the infant’s blood. Furthermore, some agents, such as levetiracetam, gabapentin or topiramate, may reach high levels in breast milk, but their serum levels in the infant remain very low. An analysis of pharmacokinetic, physicochemical and clinical parameters of a given drug provides information on the risk of its use in a breastfeeding mother. The paper discusses the general principles of drug penetration into breast milk and the factors influencing this process. Parameters of different antiepileptic drugs, which determine the safety of their use in breastfeeding women are presented along with research data and recommendations. Most of the older generation drugs are characterised by favourable pharmacokinetics, with phenytoin, carbamazepine and valproic acid considered the safest during breastfeeding. As for new generation agents, only incomplete data indicating that levetiracetam, gabapentin and lamotrigine are moderately safe during lactation, is available.