Jaye,
 If megestrol is the drug you are wondering about, it is also an
ingredient in combination type of oral contraceptives (the
progesterone portion, which is combined with estrogens), which are
considered compatible with breastfeeding but, of course, have a
concern in suppression of breastmilk supply.  Usually progesterones
are contraindicated in the first month postpartum because otherwise
Lactogenesis II can be inhibited (mimics not losing the placenta,
essentially), or it might be an issue regarding neonatal jaundice in
that first week.
So, I don't know if the dose used for cancer is tremendously higher
and poses risks for that reason but I also saw this website which
lists lots of hormonal therapies for various things and if you scroll
down far enough you'll find a section labeled "breastmilk"--while
other meds are contraindicated or okayed, the only comment on this one
has to do with the fact that it's usually used for treating breast
cancers so that that diagnosis would be the reason not to breastfeed.
http://www.intox.org/databank/documents/pharm/progest/ukpid12.htm
Also, if you can get a copy of this article from JHL, it seems to
mention megestrol acetate. jhl.sagepub.com/cgi/content/refs/9/3/187
Another website said that 0.1% is excreted in maternal milk.
 http://www.pbs.gov.au/pi/bqpmegta10103.pdf
good luck-
Susan Lawrence

> From:    "Jaye Simpson, IBCLC" <[log in to unmask]>
> Subject: Urgent request
>
> I need urgent information Re: the drugs Megace (Megestrol) and cytotec in a
> nursing mother of a 21 mo old boy with Cerebral Palsy.  I have been working
> with this mom since day 7 of baby's life through many ups and downs.
>
>
>
> Today Mom was been diagnosed with repeat endometrial cancer - Adeno
> carcinoma insitu.   Drs want her to wean immediately and start the meds
> today.  The cytotec will be the vaginal application.  We are not worried
> about this med.  It is the Megace we are concerned with and I am not finding
> any information on its safety for a baby this age - it is not listed in
> Hale, and although I am a member of his website I am unable to get it to
> work correctly to search for this info (It keeps sending me back to the
> login page.sigh).
>
>
>
> Mom has worked very, very hard to nurse this baby despite many, many
> setbacks and problems with the breastfeeding and baby's health.  She is
> absolutely opposed to weaning cold turkey - he is having feeding issues now
> - not eating solids by mouth, gets most feeds by G-Tube.  He does nurse 2-3
> times per day and receives only breastmilk - no ABM.
>
>
>
> My question is, while Megestrol is contraindicated for mothers with newborns
> but what about 21 mo olds?  The molecular weight is 384.51.  That is about
> all I know at this point. Mom is to be on the meds for 3 months in varying
> doses.  She is to start at 3 20 mg daily for 3 days, then 2 20mg tablets
> daily for 1 week, then 1 20mg tablet daily for three weeks, then 1 week off.
> She is to do this for 3 months.
>
>

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