Is HF-1854 Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use HF-1854? Is HF-1854 safe for nursing mother and child? Does HF-1854 extracts into breast milk? Does HF-1854 has any long term or short term side effects on infants? Can HF-1854 influence milk supply or can HF-1854 decrease milk supply in lactating mothers?

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Because there is little published experience with HF-1854 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 HF-1854, 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 HF-1854 not breastfeed.[2][3][4]

Among 4 infants who were breastfed by mothers taking HF-1854, 1 infant experienced drowsiness and 1 infant experienced agranulocytosis possibly caused by HF-1854. Details of the cases are lacking.[7] A healthy female infant was born to a mother who took HF-1854 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 HF-1854 in breastmilk, but it could have been the result of exposure to the drug during gestation or could have been unrelated to HF-1854.[8] One woman who took HF-1854 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, HF-1854 has a minimal effect on maternal serum prolactin levels.[9][10] However, a woman who had been taking HF-1854 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.