Is Methoxy polyethylene glycol-epoetinbeta [EMA EPAR] Safe in Breastfeeding

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

Erythropoietin is a normal component of human milk. Methoxy polyethylene glycol-Methoxy polyethylene glycol-epoetinbeta [EMA EPAR] is a synthetic form of erythropoietin that slowly releases the active drug, Methoxy polyethylene glycol-epoetinbeta [EMA EPAR]. The excretion of exogenous methoxy polyethylene glycol-Methoxy polyethylene glycol-epoetinbeta [EMA EPAR] in breastmilk has not been studied; although the similar drug epoetin alfa has been studied and is considered to be acceptable during breastfeeding. If methoxy polyethylene glycol-Methoxy polyethylene glycol-epoetinbeta [EMA EPAR] is required by the mother, it is not a reason to discontinue breastfeeding. However, since no information is available on its use during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. A study on Holder pasteurization of breastmilk found that the erythropoietin concentration in breastmilk dropped from about 1.9 international units/L before pasteurization to about 0.5 international units/L after pasteurization.[1]

Enhancement of gastrointestinal tract maturation has been proposed as a function of erythropoietin in breastmilk.[2][3]

In small studies, epoetin alfa administration decreased serum prolactin in patients with amylotrophic lateral sclerosis,[13] but had no effect in normal subjects or in patients with renal failure undergoing chronic ambulatory peritoneal dialysis.[14][15] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.