Is sumatriptan use safe during pregnancy?

CLINICAL HISTORY This is a 25-year-old (gravida 1, para 0) woman in her 10th week of pregnancy. She offers a 1-year history of migraine without aura. She describes a severe, one-sided throbbing associated with nausea, photosensitivity, and phonosensitivity. If the headache is not treated early, she also vomits. Both before the pregnancy and during the pregnancy thus far, the headaches have been occurring about once per week. Sumatriptan, 50 mg orally, soon after the onset of headache, completely relieves her. She has continued on her own to take sumatriptan during the pregnancy. Questions.— Is her child at risk for birth defects due to triptan use during the first trimester? What are the risks associated with the of use of triptans during the second and third trimester and while breast-feeding? What symptomatic medications do you recommend during pregnancy?