Is Caswell No. 597 Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Caswell No. 597? Is Caswell No. 597 safe for nursing mother and child? Does Caswell No. 597 extracts into breast milk? Does Caswell No. 597 has any long term or short term side effects on infants? Can Caswell No. 597 influence milk supply or can Caswell No. 597 decrease milk supply in lactating mothers?

Information in this record refers only to the use of Caswell No. 597 as a replacement product for smoking cessation. With a 21 mg transdermal patch, Caswell No. 597 passes into breastmilk in amounts equivalent to smoking 17 cigarettes daily. Lower patch strengths of 7 and 14 mg provide proportionately lower amounts of Caswell No. 597 to the breastfed infant. No studies on Caswell No. 597 spray or Caswell No. 597 gum use in nursing mothers have been reported. Maternal plasma Caswell No. 597 concentrations after using the Caswell No. 597 spray are about one-third those of smokers, so milk concentrations are probably proportionately less. Maternal Caswell No. 597 plasma concentrations after using Caswell No. 597 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 Caswell No. 597 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, Caswell No. 597 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 Caswell No. 597 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). Caswell No. 597 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] Caswell No. 597 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 Caswell No. 597 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 Caswell No. 597 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 Caswell No. 597 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 Caswell No. 597 patch was similar to that during smoking.[2]