Dear Anna,
I have hesitated to respond because I am sure that there are
people on Lactnet who know a tremendous amount more about this than I.
But since I haven't seen other responses, I'm going to share with you
what I do know that maybe could help. I personally did bfeed through
chemo treatment for breast cancer, but my "baby" was already 3 years old,
so it was a totally different situation. The drugs I was on were
Adriamycin and Cytoxan, very commonly used for tx of breast cancer. The
longest half life of the two was the Adriamycin, which has an AHL of
17-30 hours. I made the decision to use the more conservative estimate of
30 hours, and waited 5 half lives= 150 hours prior to nursing my son. I
felt very comfortable with this.
I have no information on whether or not exposure to certain chemo
drugs are more toxic for the newborn than others. I find it interesting
that they are willing to treat pregnant women in the third trimester with
chemo drugs, but then we generally don't recommend bfeeding. I'm not
clear why one is "okay", but the other isn't. I'm not saying that mothers
undergoing chemo should bfeed anyway- I'm just expressing my lack of
understanding. Certainly the in utero exposure is significantly higher
than it would be via bmilk, right?
There are plenty of drugs used for chemo that have a much shorter
half life than Adriamycin. It is hard to know what she will be getting-
frequently Taxol is given for a second session, but there is no reason to
guess. I don't imagine that there will be any choice about which drugs
are used. Each one is chosen for its specific properties, and my
understanding is that there wouldn't be any room for negotiation.
While bfeeding is not contraindicated with radiation treatments,
you may want to let her know that it is likely that the radiation will
damage the ducts and she will probably notice a decrease in her milk
production. I would also remind her that many women have exclusively bfed
twins and triplets, so this should not be an issue (unless she is
receiving bilateral radiation).
Finally, I just want to say that bfeeding my son after my
mastectomy and on and off through treatment was, by far, the most healing
experience I have ever had. The whole cancer experience is- gosh I can't
even think of a strong enough word- it's like this abyss filled with
terror and uncertainty which is so horrific that it feels surreal much of
the time, and it's as far removed from normal as you can be. So being
able to do something as natural and beautiful as breastfeed was like this
bridge from hell back to safety that created tremendous comfort. If there
is any way that she can breastfeed safely, I believe it will bring her
benefit beyond the obvious.
Best wishes to this mom~
Sandy Hankin in Austin, Texas
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