Child with chemo, breatsfeeding mom pregnant

[MeriH]

PTP. I have a client whose 1yr 7mos old child was just diagnosed with cancer and is starting chemo with Vincristine once per week and Actinomysin D every two weeks. Operation later in february. Mom is 12 weeks pregnant and she was told to weaning because of possible exporuse from toddlers salvia trough her nipples.

As far as I am aware, if nipples are healthy it exposure to fetus should be neglible, basically same if child drools on her skin or vomits etc.

Appreciating your help
Br,
Meri Haahtela
reg midwife, reg paramedic, reg nurse, IBCLC

[admin]

MeriH:

I can find no published data on the effects of skin exposure to Actinomycin or Vincristine, nothing at all that I could find. Actinomycin apparently is not as teratogenic as is Vincristine. Vincristine is horribly dangerous to a fetus.

That said, I do not think it advisable for the pregnant mom to breastfeed with an infant exposed to these two anticancer drugs. If she is insistent, then perhaps a nipple shield would be advisable, or to wash her nipples carefully with a baby detergent following each feeding to remove any remaining agent.

As for a risk vs benefit ratio, and with a 1 and half year old infant, I would think the RISK to the moms fetus is greater than the benefit of breastfeeding the infant at this stage. Perhaps she could pump and feed the infant her milk.

Tom Hale Ph.D.