Breastfeeding toddler is 2-and-a-half.  Just diagnosed 3 weeks ago with Acute Lymphoblastic Leukemia (ALL), and is receiving intrathecal methotrexate as a part of chemo (2 doses, 2 weeks apart).  Child is hospitalized - inpatient.  Mother has been informed that dietary folic acid inhibits the action of the methotrexate and can make the chemo less effective against the leukemia.  Mother is advised to avoid all folic acid supplementation - to try to get her own nutrients through diet alone to avoid passing folic acid to the toddler through breastmilk.  Toddler is nursing frequently for comfort so mother thinks there is probably significant milk intake but not sure.  Mom is fine with avoiding supplements, but is concerned about a possible future pregnancy and the risk of neural tube defects in a future child.  Still, she does not want to wean under any circumstances, especially not now.  

I read that nursing infants have higher folate levels even than the nursing mother herself.  Has anyone dealt with this before?  I am having difficulty figuring out how much folic acid is transferred through the milk.  The mom would like some guidelines about how to minimize folic acid in the breast milk while still maintaining her own health.

Also, does anyone know if continuing to breastfeed at this age would confer the same type of passive immunity to the immuno-compromised toddler (this child has a white blood cell count of .7) that it would have conferred to the newborn whose immune system is insufficiently developed?  Oncologists are not familiar with any specific benefits (other than psychological comfort) that continuing to breastfeed this toddler might confer.  The concern about transmitting folic acid also tends to make it seem that continuing to breastfeed during leukemia treatment could entail some risks not usually present.  I'd like to help figure out the real risk/benefit calculation.  Of course, my own sense is that continuing to breastfeed can only help, but does anyone have anything specific?

Thanks.

Pamela H. Pilch, JD
Lamaze Certified Childbirth Educator
Virginia
 
> ********************************************** 
> 

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome