Is CQ Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use CQ? Is CQ safe for nursing mother and child? Does CQ extracts into breast milk? Does CQ has any long term or short term side effects on infants? Can CQ influence milk supply or can CQ decrease milk supply in lactating mothers?

No adverse effect has been described. Anti-malarial drug used for anti-inflammatory and immune suppressive medication on collagen diseases like idiopathic arthritis or lupus. After a dose of 5 mg per kilo taken by the mother only 0.2 mg is secreted into breast milk. This amount would not be harmful for the child since the dose to a child as chemo-prophylaxis for malaria is 8 mg per kilo each week. Avoid using it in patients suffering G-6-P-dehydrogenasa. American Academy of Pediatrics: Maternal Medication Usually Compatible With Breastfeeding.

Very small amounts of CQ are excreted in breast milk; when given once weekly, the amount of drug is not sufficient to harm the infant nor is the quantity sufficient to protect the child from malaria. United Kingdom malaria treatment guidelines recommend that weekly CQ 500 mg be given until breastfeeding is completed and primaquine can be given.[1] Breastfeeding infants should receive the recommended dosages of CQ for malaria prophylaxis.[2] In HIV-infected women, elevated viral HIV loads in milk were decreased after treatment with CQ to a greater extent than other women who were treated with the combination of sulfadoxine and pyrimethamine.[3] Because no information is available on the daily use of CQ during breastfeeding, hydroxyCQ or another agent may be preferred in this situation, especially while nursing a newborn or preterm infant.

Several authors have pointed out that malaria prophylaxis in nursing mothers with CQ is common in endemic areas.[7][8][9] As of the revision date, no reports of adverse reactions in breastfed infants have been published.