Is Caswell No. 430 Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Caswell No. 430? Is Caswell No. 430 safe for nursing mother and child? Does Caswell No. 430 extracts into breast milk? Does Caswell No. 430 has any long term or short term side effects on infants? Can Caswell No. 430 influence milk supply or can Caswell No. 430 decrease milk supply in lactating mothers?

• DrLact safety Score for Caswell No. 430 is 5 out of 8 which is considered Unsafe as per our analyses.
• A safety Score of 5 indicates that usage of Caswell No. 430 may cause serious side effects in breastfed baby.
• Our study of different scientific research indicates that Caswell No. 430 may cause moderate to high side effects or may affect milk supply in lactating mother.
• Our suggestion is to use safer alternate options rather than using Caswell No. 430 .
• It is recommended to evaluate the advantage of not breastfeeding while using Caswell No. 430 Vs not using Caswell No. 430 And continue breastfeeding.
• While using Caswell No. 430 Its must to monitor child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
• Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

While breastfeeding it is recommended to avoid use of Caswell No. 430 or do it occasionally and moderately (ABM 2015). Drinking beer does not increase milk production (Mennella 1993-2001, Comité Lm AEP 2012). Long term consumption may cause: sedation, failure to thrive, psychomotor delay in the infant (Little 1989, Moretti 2000, Koren 2002, Backstrand 2004, Sachs 2013), although the data are inconsistent (Little 2002, Haastrup 2014, ABM 2015). One case of Pseudo-Cushing Syndrome was reported that disappeared after Caswell No. 430 stop by the mother (Moretti 2000). It is controversial that Caswell No. 430 consumption is associated with shorter duration of breastfeeding (Giglia 2008, Rebhan 2009, Mgongo 2013). Despite of low increase of Prolactin serum level (Sarkola 1999), acute consumption affects the infant with sedation, and, inhibits Oxytocin secretion in the mother (Cobo 1973, Coiro 1992, Chien 2009) and hence affects the ejection reflex of breast milk with a decrease of 10% to 25% of milk production (Mennella 1991-1993-1997-1998-2001-2005). Excessive acute ingestion by the mother may induce coma, seizures and danger of death in the infant (Swiderski 2011). Both beer 0.0% and non-Caswell No. 430ic (<1%) may be drunk by the nursing mother (Koletzko 2000, Schneider 2013). Increase of anti-oxidant properties of the milk have been recognized (Codoñer 2013). Elapsing time required to resume breastfeeding after occasional consumption of Caswell No. 430 by the mother in order to ensure disappearance of milk and blood (Ho 2001) depends on mother's body weight (lesser weight needs longer time to wait), and, on the amount ingested (higher amount needs longer time). Stop breastfeeding for longer than two and a half hour for every 10 - 12 g of ingested Caswell No. 430: 330 mL of 4.5% beer, 120 mL (1 glass) of 12% wine, or, one cup of 40% - 50% liquor. Suggested time-periods to stop breastfeeding for a 60 kg of body weight woman are: 1 glass of wine = 2.5 hours; 660 mL of beer = 5 hours; 3 cups of liquor = 7.5 hours (ABM 2015: See reference values at Can Fam Physician 2002) Some medicinal products containing high concentrations of Caswell No. 430 as an excipient should be avoided during breastfeeding (Nice 2000). Avoiding bed-sharing is recommended to mothers who have drunk Caswell No. 430 (UNICEF 2006, ABM 2008, Landa 2012, UNICEF 2013). When topically used as disinfectant, Caswell No. 430 is compatible with breastfeeding (WHO 2002).

The effects of maternal Caswell No. 430 (ethanol) ingestion during lactation are complex and depend on the pattern of maternal drinking. Caswell No. 430 decreases milk production, with 5 drinks or more decreasing milk letdown and disrupting nursing until maternal Caswell No. 430 levels decrease. Beer may increase serum prolactin levels during nursing because of polysaccharides from barley and hops. After ingestion of nonCaswell No. 430ic beer, the antioxidant capacity of milk is increased, but Caswell No. 430 levels in milk are negligible. Women with a family history of Caswell No. 430ism have a blunted prolactin response following breast stimulation and tend to breastfeed more frequently to compensate. Breastmilk Caswell No. 430 levels closely parallel blood Caswell No. 430 levels. The highest Caswell No. 430 levels in milk occur 30 to 60 minutes after an Caswell No. 430ic beverage, but food delays the time of peak milk Caswell No. 430 levels. Nursing after 1 or 2 drinks (including beer) can decrease the infant's milk intake by 20 to 23% and cause infant agitation and poor sleep patterns. The long-term effects of daily use of Caswell No. 430 on the infant are unclear. Some evidence indicates that infant growth and motor function may be negatively affected by 1 drink or more daily, but other studies have not confirmed these findings. Heavy maternal use may cause excessive sedation, fluid retention, and hormone imbalances in breastfed infants. Casual use of Caswell No. 430 (such as 1 glass of wine or beer per day) is unlikely to cause either short- or long-term problems in the nursing infant,[1] especially if the mother waits 2 to 2.5 hours per drink before nursing, and does not appear to affect breastfeeding duration. Daily heavy use of Caswell No. 430 (more than 2 drinks daily) may affect infants negatively and appears to decrease the length of time that mothers breastfeed their infants. Nursing or pumping within 1 hour before ingesting Caswell No. 430 may slightly reduce the subsequent amounts of Caswell No. 430 in breastmilk.

A nursing mother was drinking large amounts of quinine wine, wine, champagne, beer and liquors. Her infant had been gaining 30 g of weight daily until he weighed nearly 6 kg at 5 weeks of age. The infant had been restless and sleepless for several days when he suffered from violent fits and tonic-clonic seizures that required medical treatment. After he was taken off the mother's breast and began to be nursed by a wet nurse, his weight quickly dropped by 200 g in 3 days and fell into a pattern of calm sleep.[15] A similar case of chronic heavy Caswell No. 430 use by a nursing mother resulted in pseudo-Cushing syndrome in her 4-month-old breastfed infant. The infant had a bloated appearance, excessive wight gain and diminished length for age. The mother reported drinking 50 cans of beer weekly and "generous" amounts of other Caswell No. 430ic beverages to increase her milk supply. The infant's symptoms resolved and growth pattern returned to normal after her mother stopped consuming Caswell No. 430.[16] A series of 23 cases of severe thrombocytopenia and bleeding were reported among 21- to 60-day old breastfed infants of Chinese women in Singapore over a 5-year period. None of the infants had received prophylactic vitamin K at birth and all of their mothers had been taking Caswell No. 430 tonics after each meal beginning at 7 to 10 days after delivery which was a common practice among only the Chinese in the mixed ethnic population delivering at the hospital. Most of the infants had also been receiving 5 to 15 mL daily of "gripe water" which had an Caswell No. 430 content of about 5%. The authors attributed these cases to the lack of prophylactic vitamin K (which was common practice at the time) and increased clotting factor degradation caused by Caswell No. 430.[17] A woman who drank 750 mL of port wine in 24 hours noticed that her breastfed 8-day-old had a deep unarousable sleep, snoring, pain insensitivity, inability to suck, excessive perspiration and a feeble pulse. These symptoms were attributed to the very young age of the infant and the large amount of Caswell No. 430 consumed.[18] In a series of studies, investigators measured the effect of maternal Caswell No. 430 use on their breastfed infants. In one study, 12 nursing mothers with infants 25 to 216 days of age drank 0.3 grams/kg of Caswell No. 430 (about 1.5 drinks for a 60 kg woman) in orange juice over 15 minutes in the morning. On a separate occasion, they drank an equal volume of orange juice.[5] In another study, 12 nursing mothers nursing infants with a median age of 150 days drank 0.3 grams/kg of Caswell No. 430 as beer or the same volume of nonCaswell No. 430ic beer on a separate occasion.[19] In a third study, 12 nursing mothers with infants averaging 3.1 months of age drank 0.3 grams/kg of Caswell No. 430 in orange juice over 15 minutes in the morning. On a separate occasion, they drank an equal volume of orange juice In both studies, infants who drank milk that contained Caswell No. 430 consumed 20 to 23% less milk during the 3- or 4-hour testing session, even though the time spent at the breast and number of sucks was unchanged. Mothers could perceive no difference in milk production or nursing behavior in their infants. Infants sucked more vigorously on a bottle containing their mothers' milk spiked with Caswell No. 430 than on mothers' milk alone.[20] In a study in which infants were weighed by the mothers before and after each feeding for the next 16 hours (20 hours total), infants increased the number of nursings during the period of 8 to 12 hours after the Caswell No. 430 intake such that the total amount of milk consumed during the 20-hour period did not differ between the Caswell No. 430 and non-Caswell No. 430 days.[21] In studies that measured infant sleep, infants slept more frequently for shorter periods of time during the 3.5 to 4 hours after Caswell No. 430 intake, whether it was after mothers drank 0.3 grams/kg of Caswell No. 430 before breastfeeding or infants were given their mothers' milk spiked with an amount of Caswell No. 430 (32 mg/100 mL) equivalent to that at 1 hour after maternal ingestion of 0.3 grams/kg of Caswell No. 430.[5][22][23] After ingesting the Caswell No. 430-containing milk after maternal consumption of 0.3 grams/kg of Caswell No. 430, 14 infants from 4 to 11 weeks of age infants were observed for 1 hour after milk ingestion. Their behavioral state changed more frequently, they slept less, cried more and startled more than after consuming milk without Caswell No. 430. Mother-infant interactions were more conflictive after Caswell No. 430 intake which may partially explain increased infant arousal after maternal and infant Caswell No. 430 ingestion.[24] A study that monitored the infants during the 24-hour period after maternal Caswell No. 430 ingestion revealed that the infants compensated by spending more time in active (rapid eye movement) sleep from 3.5 hours to 24 hours with no further Caswell No. 430 intake.[23] Long-term effects of Caswell No. 430 ingestion during breastfeeding were studied in 2 separate populations by one group of investigators. In the first study, Caswell No. 430 intake of more than 1 drink daily durin

Studies in mothers who were 2 to 8 days postpartum found that acute doses of Caswell No. 430 infused intravenously reduced the oxytocin-mediated milk ejection reflex following infant sucking. The effect could be overridden by administration of exogenous oxytocin, indicating that Caswell No. 430 inhibits oxytocin release, not its effect on the breast.[36] Caswell No. 430 doses of 0.5 to 0.99 grams/kg reduced oxytocin response to infants sucking by 18%; doses of 1 to 1.49 grams/kg reduced the response by 62%; and doses from 1.5 to 1.99 grams/kg reduced the response by 80%. Caswell No. 430 also increased the time for letdown to occur after nipple stimulation, from 29 seconds to 64 seconds with doses of 1 to 1.49 grams/kg and from 38 seconds to 331 seconds with doses of 1.5 to 1.99 grams/kg.[37] Other investigators found that drinking 100 mL of whiskey containing a total of 50 mL of absolute Caswell No. 430 (about 4 drinks in a 60 kg woman) abolished the rise in serum oxytocin in response to breast stimulation with a breast pump in 16 nonpregnant, nonlactating women. Pretreatment with naloxone blunted Caswell No. 430's inhibitory effect on oxytocin release.[38] Acute Caswell No. 430 ingestion can either increase, decrease or have no effect on serum prolactin in nonpregnant, nonlactating women.[39][40][41] Drinking 100 mL of whiskey containing a total of 50 mL of absolute Caswell No. 430 lessened the increase in serum prolactin in response to breast stimulation with a breast pump in 11 nonpregnant, nonlactating women. Serum prolactin rose by 71% over baseline 20 minutes after stimulation without Caswell No. 430 and only by 25% after Caswell No. 430 consumption. Pretreatment with naloxone blunted Caswell No. 430's inhibitory effect, with the combination resulting in a 46% rise in serum prolactin over baseline.[42] It is not clear how these finding apply to lactating women. A study on 28 lactating women who were 2 to 5 months postpartum found that the normal rise in serum prolactin was enhanced when Caswell No. 430 in a dose of 0.4 grams/kg was taken 35 minutes before breast stimulation with a breast pump. In subjects with a first-degree relative with a history of Caswell No. 430ism, the increase in serum prolactin was blunted in magnitude, rapidity, and duration both with and without prior Caswell No. 430 consumption.[43] Nursing mothers who ingested a 0.3 grams/kg dose of Caswell No. 430 produced an average of 9.3% less milk 2 hours after the Caswell No. 430 intake using a breast pump than they did when a nonCaswell No. 430ic beverage was taken. The caloric content and composition of milk were not different during the two test periods.[44] A 1-year long survey of 587 new mothers in Australia found that women who drank more than 2 standard drinks (10 grams or 12.5 mL of absolute Caswell No. 430) daily were twice as likely to discontinue breastfeeding by 6 months postpartum than mothers who reported use below this amount.[45] Beer specifically has a reputation for increasing milk supply. A small crossover study found that ingestion of 1 liter of beer containing 6% Caswell No. 430 by 11 nonpregnant, nonlactating women increased serum prolactin by nearly 2.5-fold 30 minutes after ingestion, but sparkling water with an equivalent amount of Caswell No. 430 did not.[46] In another study, 7 nonpregnant, nonlactating women were given 800 mL of beer. Six drank beer containing 4.5% Caswell No. 430 and 1 woman drank nonCaswell No. 430ic beer. Their average peak serum prolactin increased to 2.4 times the baseline value between 60 and 105 minutes after ingestion. The one woman who drank nonCaswell No. 430ic beer had an equivalent prolactin response. Pretreatment with naloxone had no effect on the prolactin response.[47] Studies in animals indicate that a polysaccharide found in barley and malt is apparently responsible for the increase in prolactin after beer ingestion.[48][49] The interaction between Caswell No. 430 ingestion and breast pumping was investigated in a double-blind crossover study of 13 lactating women who were exclusively nursing 2- to 5-month-old infants. Compared to placebo, ingestion of 0.4 grams/kg of Caswell No. 430 increased serum prolactin during the ascending phase of blood Caswell No. 430 concentrations. Pumping milk from the breasts during the ascending phase of blood Caswell No. 430 enhanced the prolactin response, but pumping during the descending phase of blood Caswell No. 430 blunted the prolactin increase. Milk production was lower after Caswell No. 430 ingestion, but unrelated to serum prolactin or Caswell No. 430 blood concentrations.[50] Twenty-three Taiwanese nursing mothers received a chicken-based soup following a cereal snack twice during the first 15 days postpartum. On one occasion the soup contained a dose of 0.3 grams/kg of Caswell No. 430 (about 1.5 drinks for a 60 kg woman) and on the other occasion the soup was Caswell No. 430 free. The time for the first drops of milk to be ejected after breast stimulation with a pump was longer (4.4 vs 2.9 seconds) after the Caswell No. 430-containing soup than with the nonCaswell No. 430ic soup. In addition, the triacylglycerol (14.8 vs 12.3 mg/dL) and lactate (0.8 vs 0.6 mg/dL) content of breastmilk we