Is C1 Esterase Inhibitor Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use C1 Esterase Inhibitor? Is C1 Esterase Inhibitor safe for nursing mother and child? Does C1 Esterase Inhibitor extracts into breast milk? Does C1 Esterase Inhibitor has any long term or short term side effects on infants? Can C1 Esterase Inhibitor influence milk supply or can C1 Esterase Inhibitor decrease milk supply in lactating mothers?

C1 esterase inhibitor [human] is a serine proteinase inhibitor derived from human plasma that is used in treating hereditary angioedema. Breastmilk levels of C1 esterase inhibitor have not been measured after exogenous administration in humans. Because of its large molecular weight, amounts in milk are expected to be small. Any C1 esterase inhibitor in breastmilk is probably destroyed in the infant's gastrointestinal tract and not absorbed, except perhaps in neonates. Various international consensus panels state that human plasma-derived C1 esterase inhibitor is considered to be the therapy of choice for both treatment and prophylaxis of maternal hereditary angioedema during lactation.[1][2]

Three patients with hereditary angioedema received C1 esterase inhibitor concentrate on 12 occasions to relieve abdominal edematous episodes during breastfeeding. No adverse reactions were reported.[3] In a case series spanning 12 years, 21 mothers with hereditary angioedema breastfed their infants for a median duration of 4.8 months (range 1 to 34 months) while receiving C1 esterase inhibitor concentrate as needed. No side effects occurred tin the breastfed infants.[4] A pregnant woman with severe hereditary angioedema required 500 IU of C1 inhibitor concentrate every 2 days to maintain her pregnancy. Postpartum, she received 500 IU on demand while breastfeeding. She used 88 vitals during her 6-month breastfeeding (extent not stated) period. No side effects or viral transmission were reported and or virus anti-C1-INH antibodies were not detected.[5] A woman with hereditary angioedema received C1 inhibitor concentrate 1000 units every week during pregnancy. Postpartum she used 500 units as needed. She and her breastfed infant were reportedly healthy.[6]