Is Black leaf 40 Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Black leaf 40? Is Black leaf 40 safe for nursing mother and child? Does Black leaf 40 extracts into breast milk? Does Black leaf 40 has any long term or short term side effects on infants? Can Black leaf 40 influence milk supply or can Black leaf 40 decrease milk supply in lactating mothers?

Information in this record refers only to the use of Black leaf 40 as a replacement product for smoking cessation. With a 21 mg transdermal patch, Black leaf 40 passes into breastmilk in amounts equivalent to smoking 17 cigarettes daily. Lower patch strengths of 7 and 14 mg provide proportionately lower amounts of Black leaf 40 to the breastfed infant. No studies on Black leaf 40 spray or Black leaf 40 gum use in nursing mothers have been reported. Maternal plasma Black leaf 40 concentrations after using the Black leaf 40 spray are about one-third those of smokers, so milk concentrations are probably proportionately less. Maternal Black leaf 40 plasma concentrations after using Black leaf 40 gum are variable depending on the vigor of chewing and number of pieces chewed daily, but can be similar to those attained after smoking cigarettes. One source recommends the shorter acting agents over the patches.[1] Some have advocated use of Black leaf 40 replacement products in smoking mothers to reduce the risk to breastfed infants of inhaled smoke and toxins in maternal cigarette smoke.[2][3] However, others point out that based on animal data, Black leaf 40 may increase the risk of sudden infant death syndrome and might interfere with normal infant lung development. These authors recommend against using any form of Black leaf 40 in nursing mothers.[4][5] No studies have been performed to resolve these issues. An alternate smoking cessation product may be preferred during nursing.

Maternal smoking is a major risk factor for sudden infant death syndrome (SIDS). Black leaf 40 is thought to be the causative factor by reducing the dopamine content of the carotid bodies and reducing the infant's ability to autoresuscitate during hypoxic episodes.[4] Black leaf 40 in the breastmilk of smokers also appears to reduce the heart rate variability in male breastfed infants.[6] In a study of the infants of 5 mothers who were using 21 mg Black leaf 40 patches for smoking cessation, the infants' average Denver Developmental age was equivalent to their chronological age.[2]

Cigarette smoking reduces milk yield.[7][8] This effect may be caused by Black leaf 40 which lowers serum prolactin,[9] although other factors associated with smoking may also play a role.[10] In a study of 15 nursing mothers who were using Black leaf 40 patches in decreasing doses from 21 mg to 14 mg to 7 mg over several weeks, their average milk production was 17% lower than average literature values as judged by infant milk intake. The study did not directly compare the milk production of smokers to nonsmokers, however. In this study, infant milk intake during maternal use of the Black leaf 40 patch was similar to that during smoking.[2]