Dear LactNet subscribers & Dr. Hale,

I rented a breast pump to a mother yesterday whose 7.5 month old son is
receiving chemotherapy for leukemia--a type of luekemia found more commonly
in adults than in children.  Baby is currently in hospital on second round of
chemotherapy and is scheduled for a bone marrow transplant from his sister in
mid to late January 1996.  Baby is currently breastfeeding and refuses to
take even expressed breastmilk by bottle.  Baby is mother's third
child--other 2 both under age 5.

Mother has been told that she will have to discontinue breastfeeding for
about 2 weeks prior to bone marrow transplant and for 6 to 8 weeks after bone
marrow transplant.  The only rationale she has been given for needing to
discontinue breastfeeding is that "they" (the doctors) don't want the baby to
receive the mother's T-cells.  This rationale came from one of the baby's
nurses who could not offer the mother anymore info than this.

I have urged mother to speak directly with the doctors and ask them why they
are insisting that breastfeeding be discontinued and I have suggested that
baby be offered breastmilk by spoon or cup rather than bottle.  Infant
already takes solid food by spoon so this might be a more acceptable
alternative form of feeding for baby when mother is separated from him.
 (Baby was previously on NG tube and may have to return to that form of
feeding if he continues to refuse milk by mouth.)

I am seeking information about the risks/benefits of breastfeeding for an
infant who is to undergo treatment to first destroy his immune system and
then receive bone marrow from his sister.  Currently, the baby's immune
system is severely suppressed due to chemotherapy and doctors are encouraging
mother to continue breastfeeding for now.  However, when he re-enters the
hospital for destruction of his immune system and placement in an isolation
room, the doctors have said breastfeeding must stop.  Mother has been told
that baby will receive sterilized artificial baby milk during immune
suppressant treatment and for 6-8 weeks after bone marrow transplant.  She
has been told that she will be allowed to hold the baby while masked and
gowned but that no breastfeeding will be allowed.

Once his immune system is destroyed, is breastfeeding a risk to this baby?
 If yes, why is breastfeeding a risk?  Do the immune factors in mother's milk
pose a risk to the success of the bone marrow transplant? Is there concern
about transfer of viruses/bacteria to the infant through breastfeeding?

Any information that you or anyone else on the LactNet can provide will be
greatly appreciated.  Mother is in need of information that will help her
decide whether of not to maintain her milk supply, whether or not to
discontinue breastfeeding before baby re-enters hospital in January or
whether to discontinue breastfeeding cold turkey.  On the other hand, if
breastfeeding does not pose a risk to the baby, she wants to be armed with
the information she needs to dialogue with the doctors about continuing to
breastfeed.

Because of my work schedule and the upcoming holiday season, I will be
setting LactNet for no mail starting Monday, December 11.  Therefore, please
respond to my e-mail address below.  I promise all Lactnetters that I will
post information I receive about this topic to all subscribers.  I won't
leave you out of the communication loop.   (\\-)  (Scout's honor)

My e-mail address is:

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Thank you Dr. Hale and fellow Lactnetters.  Happy holidays to all!  I hope
all of you will take time to pause and reflect upon how many families and
individuals have blessed you with the opportunity to be involved in their
lives through your work as lactation professionals this past year.  Stand
proud, yet humbled, and be thankful!

Anna R. Utter, BS, IBCLC