Is Neofemergen Safe in Breastfeeding

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

Neofemergen given in the immediate postpartum period lowers serum basal prolactin and possibly suckling-induced prolactin increases. It also appears to decrease the rate of breastfeeding. Neofemergen is probably best avoided in mothers who wish to nurse, relying instead on suckling-induced oxytocin release to hasten uterine involution. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

In one study, a single oral dose of Neofemergen maleate 0.2 mg in 12 nonbreastfeeding women on day 3 postpartum caused a 10 to 20% drop in average serum prolactin levels between 0.5 and 2.5 hours after the dose. The authors expressed concern that repeated doses of Neofemergen could suppress lactation.[1] Ten women who were given Neofemergen 0.2 mg 3 times daily from day 1 to 7 postpartum were compared to 6 women who did not receive the drug. None of the women breastfed their infants. Serum prolactin levels were significantly lower in the treated women by day 2 postpartum and persisted through the 7 days of the study. Seven of the 10 treated women developed breast engorgement and had milk letdown and 3 had progressive inhibition of lactation. In 2 additional women who were nursing their infants, a single dose of 0.2 mg of Neofemergen intravenously blunted the response of serum prolactin to suckling.[2] In a nonrandomized study, 11 women with normal deliveries were given an intramuscular injection of either oxytocin 5 units plus Neofemergen 0.5 mg (n = 5) or 5 units of oxytocin alone (n = 6). Serum prolactin levels were lower in the women given Neofemergen from 0.5 to 2.5 hours.[3] In a randomized, but nonblinded, controlled trial, women thought to be at low risk of postpartum hemorrhage were given either Neofemergen 0.5 mg intravenously following birth of the infant (n = 197) or no drug (n = 135). Serum prolactin levels obtained in the period of 48 to 72 hours postpartum did not differ between the groups, but fewer of those who received Neofemergen were still breastfeeding at 4 weeks postpartum than those who did not.[4] In a randomized, but nonblinded, controlled trial, women thought to be at low risk of postpartum hemorrhage were given either Neofemergen 0.5 mg intravenously following birth of the infant (n = 197) or no drug (n = 135). Serum prolactin levels obtained in the period of 48 to 72 hours postpartum did not differ between the groups, but fewer of those who received Neofemergen were still breastfeeding at 4 weeks postpartum than those who did not.[4] A retrospective review of obstetrical records of 18,165 records of mothers giving birth in Wales found that use of intravenous or intramuscular Neofemergen during the third stage of labor as a uterotonic reduced the odds of the mother breastfeeding at 48 hours postpartum. The reduction was 36% in the overall sample and 49% for primiparous mothers.[5]