You've been poked and prodded, scanned and biopsied. You've come through bad news and scares, surgeries and treatments. No one needs to tell you that you and your breasts have been through a lot. But you're a survivor who has plenty to look forward to: your brand-new baby!
And while your history of breast cancer shouldn't impact your pregnancy, it might impact what happens after pregnancy — at least when it comes to breastfeeding your little bundle of joy.
Can you breastfeed after having breast cancer?
The truth is, breastfeeding can be challenging for any new mom, but for a new mom who's also beaten breast cancer, nursing a baby can be even more complicated.
Happily, research suggests that nursing after breast cancer is possible, and in most cases a breast cancer survivor can at least try to nurse her baby if she wants to — even on the treated breast.[1] And since breastfeeding may protect against breast cancer coming back, nursing may benefit both you and your baby (who'll reap the rewards from drinking your nutrient-rich breast milk).
How cancer treatments can impact breastfeeding
Whether you'll be able to breastfeed successfully and whether your milk is safe for your baby depends on the type of treatment you received. If you haven't yet undergone treatment for breast cancer, most doctors recommend avoiding breastfeeding. Doing so before surgery reduces blood flow to the breasts and makes them smaller (which is helpful for the operation and reduces the risk of infection).
Each case is different, of course, but here's the basic lowdown on how each type of treatment affects your ability to nurse your little one:
Lumpectomy
Your ability to nurse successfully from the affected breast depends how much tissue was removed and whether or not you had radiation (and how much). Most women with a minimal lumpectomy are able to produce some milk from the treated side.
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Single mastectomy
Breastfeeding from the unaffected breast should be possible. Experts say that although it may produce only limited milk at first, by nursing and pumping frequently (things any woman looking to boost milk supply needs to do) — and with the support of your family and a lactation expert — you'll likely be able to breastfeed successfully.
Double mastectomy
Since there are no milk ducts left, unfortunately you won't be able to breastfeed your baby.
Radiation
If you're currently undergoing external beam radiation therapy, you don't need to take any special precautions around others, and it is considered safe to nurse (but ask your doctor to be sure).
If you've undergone a lot of radiation, the damage to your breast tissue might be too extensive for the milk ducts to be productive, which means there's a good chance the treated breast won't be able to produce a lot of milk. Some practitioners also advise against breastfeeding from an irradiated breast due to the difficulty treating infections (mastitis), which are more common with breastfeeding.
Chemotherapy
You won't be able to nurse your baby while getting chemo, and you'll likely have to wait a specific amount of time after you've finished treatments before you're able to breastfeed. You'll need to ask your oncologist, the OB/GYN and/or your lactation consultant when your milk will be safe again.
Some drugs require a wait of three to four months or more, while other drugs need only a few days to weeks to leave your system entirely. If it's a short amount of time, you might be able to "pump and dump" until your milk is safe again.
Hormone therapy
If you're taking long-term medications including Tamoxifen, an aromatase inhibitor or trastuzumab, you won't be able to nurse your baby because the drugs get into breast milk and they're not safe for the baby.
Tips for nursing after breast cancer
Remember the rule about breast milk supply and demand: The more you nurse, the more milk will be produced. This rule applies even more after breast cancer, so you'll need to intensify your efforts to pump up your supply. A really good double electric pump can help, as well as talking to a lactation consultant, who can help address problems like low milk supply and cracked nipples.
Don't be discouraged, however, if your milk supply never ramps up enough to exclusively breastfeed. You can easily add bottles of formula to supplement breastfeeding so that you and your baby get the best of both worlds.
You also might also want to consider using a supplemental nursing system (SNS) — a narrow flexible tube taped to your breast that extends slightly past your nipple and draws on a bottle of formula. As your baby suckles at your breast, he'll also be drinking formula, stimulating your breast(s) while your baby gets the food he needs.
Something else to consider depending on the type of treatment you had: your nursing bra. If you're nursing from only one breast (because, say, the other breast can't produce milk), the milk-producing breast will be larger (thanks to engorgement) than the non-nursing one. If the lopsidedness bothers you, use a silicone bra cup insert to fill out the smaller side.
If you're unable to breastfeed because of your breast cancer, don't feel guilty. Remember, you're no less of a mom because your little one's form of nutrition comes from a bottle instead of your breast. There are plenty of ways to bottle-feed with love, and bottle-feeding gives you more than enough opportunities to snuggle and bond with your baby. The important thing is that you're here, you're healthy and you're giving your baby the love and care he needs.
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