Is 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine? Is 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine safe for nursing mother and child? Does 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine extracts into breast milk? Does 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine has any long term or short term side effects on infants? Can 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine influence milk supply or can 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine decrease milk supply in lactating mothers?

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Because there is little published experience with 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine during breastfeeding, and sedation and adverse hematologic effects have been reported in breastfed infants, other agents are preferred.[1] If breastfeeding is undertaken by a mother who is taking 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine, close monitoring of the infant for excessive sedation and periodic monitoring of the infant's white blood cell count is advisable. Several authoritative sources recommend that women taking 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine not breastfeed.[2][3][4]

Among 4 infants who were breastfed by mothers taking 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine, 1 infant experienced drowsiness and 1 infant experienced agranulocytosis possibly caused by 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine. Details of the cases are lacking.[7] A healthy female infant was born to a mother who took 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine 100 mg daily throughout pregnancy and lactation. She was breastfed (extent not stated) up to 1 year of age. The infant developed normally except for speech which was delayed considerably. She did not achieve normal, fluent speech until the age of 5 years. The delayed speech development was possibly related to 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine in breastmilk, but it could have been the result of exposure to the drug during gestation or could have been unrelated to 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine.[8] One woman who took 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine 100 mg daily in late pregnancy and postpartum partially breastfed her infant for 5 days. No neurodevelopmental disorders were detected in the infant after 32 months of follow-up.[6]

Unlike the phenothiazines, 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine has a minimal effect on maternal serum prolactin levels.[9][10] However, a woman who had been taking 8-Chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo(b,e)(1,4)diazepine plus high-dose haloperidol developed hyperprolactinemia and severe galactorrhea 2 weeks after stopping haloperidol and 4 days after starting valproic acid. A dose of cabergoline normalized her serum prolactin and galactorrhea ceased for the following 2 months of observation.[11] The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.