Is NSC 5065 Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use NSC 5065? Is NSC 5065 safe for nursing mother and child? Does NSC 5065 extracts into breast milk? Does NSC 5065 has any long term or short term side effects on infants? Can NSC 5065 influence milk supply or can NSC 5065 decrease milk supply in lactating mothers?

Information in this record refers only to the use of NSC 5065 as a replacement product for smoking cessation. With a 21 mg transdermal patch, NSC 5065 passes into breastmilk in amounts equivalent to smoking 17 cigarettes daily. Lower patch strengths of 7 and 14 mg provide proportionately lower amounts of NSC 5065 to the breastfed infant. No studies on NSC 5065 spray or NSC 5065 gum use in nursing mothers have been reported. Maternal plasma NSC 5065 concentrations after using the NSC 5065 spray are about one-third those of smokers, so milk concentrations are probably proportionately less. Maternal NSC 5065 plasma concentrations after using NSC 5065 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 NSC 5065 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, NSC 5065 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 NSC 5065 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). NSC 5065 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] NSC 5065 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 NSC 5065 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 NSC 5065 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 NSC 5065 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 NSC 5065 patch was similar to that during smoking.[2]