Breast-feeding benefits babies and mothers in countless ways. But what should a mom do if cancer suddenly enters the picture? Whether chemotherapy, surgery, or radiation therapy is part of the treatment plan, many women thrust into this situation have questions about the best next steps for their babies and themselves.
Registered nurse Jennifer Simon knows a lot about this topic. She’s been an oncology nurse for years, is internationally board certified as a lactation consultant, and spearheaded Memorial Sloan Kettering’s Lactation Task Force.
“Many women who learn they’ll have to take medications or begin a cancer treatment assume they’ll have to wean,” she says. “But the truth is that many women have a choice.”
Breast-feeding and Chemotherapy Drugs
Many medications are compatible with breast-feeding. Examples include ibuprofen for pain relief and various inhalers to control asthma.
Chemotherapy drugs are a different story, however. Mothers cannot breast-feed while receiving chemotherapy drugs. They’re dangerous for nursing infants because they interfere with the normal, healthy division of cells in the body. That said, women can make an informed decision on how they want to proceed: wean their infant or pump and discard milk during the course of treatment and until their doctor says it’s safe to resume.
The National Institutes of Health’s LactMed database, Medications and Mothers’ Milk Online, and other evidence-based resources guide doctors and others in prescribing medications, including chemotherapy, for women who are lactating. The resources explain how, and to what degree, a drug a woman is exposed to enters the breast milk — and what level of risk this poses to the breast-fed baby.
Breast-feeding before and after Surgery
The key with surgery is to plan ahead, Ms. Simon says. If possible, pump and store a supply of breast milk before your surgery or procedure. That way your baby can continue to be fed your breast milk while you’re separated.
She also advises asking what type of medication you’ll be getting. For example, while anesthesia medicines to make you sleep during a procedure don’t stay in the body for very long, you should ask the anesthesiologist about what you’ll be getting and how long to wait before breast-feeding again.
On the day of the surgery or procedure, remind the team that you’re breast-feeding and wish to continue.
MSK’s Preparing for Your Surgery or Procedure While You Are Breast-feeding or Lactating has detailed information on supplies you should bring to the hospital, what to do if you expect to be away from your baby for more than 24 hours, and other helpful tips and resources to support you if you want to continue to breast-feed.
Breast-feeding during Radiation Therapy
It’s important to speak with your doctor if you’re having any type of radiation treatment for cancer. The level of risk this form of treatment poses depends in part on what area of your body will be exposed to radiation, and what form of radiation you’ll be getting.
For example, the most common form of treatment — external beam radiation — is usually safe when you’re breast-feeding so long as you’re not receiving chemotherapy at the same time. But there are some exceptions, so talk to your doctor. The risks associated with brachytherapy, a form of internal radiation, depend on factors such as how long the implant containing radioactive material has been in your body.
Empowering Mothers to Make a Breast-feeding Decision
Many women are relieved to learn that they have options and that their healthcare team is available to help guide them.
“I hear a lot of mothers say they’re eager to avoid interrupting the breast-feeding connection to their baby,” says Ms. Simon. She adds that they often get enormous comfort from being able to nourish their child at a time of upheaval in their lives. Breast-feeding also causes a release of oxytocin, a hormone that can help in feeling more relaxed and less anxious.
Other women decide to wean their baby. They may see the challenges as too great when also dealing with cancer. Or they know they’ll be separated from their baby for long stretches of time. “It’s up to the mothers to decide,” says Ms. Simon. “It’s a personal choice. We want them to be informed, and we support them either way.”
To do that, MSK is currently building a system that identifies patients facing the breastfeeding question, and then empowering them with solid, evidenced-based information. “We ask women, ‘Is weaning what you want to do?’” explains Ms. Simon. “And then we explain how we look at the medicines they’ll need and what we know are good guidelines. By using dependable resources such as the National Institutes of Health’s LactMed database and Medications and Mothers’ Milk Online we can look for a different — and safe — medication alternative” if necessary, Ms. Simon explains.
Overall, the key to safe and healthy breast-feeding during active cancer treatment of any kind is to keep communicating with your healthcare team, says Ms. Simon. Before breast-feeding, always first talk to your oncologist, surgeon, and pediatrician about whether it’s safe to do so.