Re: the adoptive mom who is on tamoxifen for cancer:

This seems to be the only piece of the puzzle that others haven't addressed.
According to Hale, "the significant risks of tamoxifen probably outweigh the
benefits of breastfeeding.  Mothers receiving tamoxifen should not bf until
we know more about the levels transferred into milk."

But there's more.  Apparently tamoxifen does a pretty good job of
suppressing lactation (and prolactin), at least at the outset.  It's not
clear what effect it has on established lactation.

If I were this mother, I'd go ahead and breastfeed, with donor milk to
whatever extent possible.  But I'd nurse in a way that doesn't encourage a
milk supply.  I might, for instance, spend one day nursing on one side, then
one day on the other.  And of course no pumping to prepare.  I'd hand
express periodically to make sure I wasn't producing milk - or wasn't
producing very much.

Beyond that, I'd simply enjoy nursing my baby.  Odds are, in an adoptive
situation and with the kind of suppression tamoxifen offers, this mother
won't need to worry about whether or not her meds are a concern.
--
Diane Wiessinger, MS, IBCLC  Ithaca, NY
www.wiessinger.baka.com

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