Hi.  I'm Diane Wiessinger from Ithaca, NY.  I'm an LC in private (and very
small) practice for about 3 years and a LLL Leader for about 10.  I had
intended to "lurk" longer, but I have a question that won't keep.
My client discovered a malignant breast lump 2 weeks before the birth of
her first baby, now 9 days old.  She'll have the lump and some nodes
excised in about a week;  6 months of chemotherapy will start in 6 to 8
weeks.
Conventional wisdom says don't nurse during chemo, but there appear to be
scant studies.  USPDI 1989 says of tamoxifen:  "Although very little
information is available... breastfeeding is not recommended... because of
risks to the infant... It is not known whether tamoxifen is excreted in
breastmilk."
Ruth Lawrence's book says tamoxifen is more than 99% plasma protein
bound;  my understanding is that such drugs are generally in extremely low
concentrations in human milk.
Anyone have any experience/studies/thoughts on partial or full
breastfeeding during chemo, or on nursing without milk transfer (e.g.
blind nipple shield and supplementer)?
My best thought - if she wants to consider it - is check out theoretical
risks of drugs recommended to her.  If questionable, like tamoxifen, have
milk tested (anyone know where??) after chemo begins.  If acceptably low or
absent, nurse and monitor baby's blood.
How nice to have people to ask :)