Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: How should we counsel cancer patients about breastfeeding?

Pistilli, Barbara; Bellettini, Giulia; Giovannetti, Elisa; Codacci-Pisanelli, Giovanni; Azim, Hatem Hamdy Abdel; Benedetti, Giovanni; Sarno, Maria; Peccatori, Fedro Alessandro

doi:10.1016/j.ctrv.2012.10.002

Cited by 54 publications

(34 citation statements)

References 45 publications

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“…While most over-the-counter drugs and antibiotics are not contraindicated during breast feeding [11,12], when it comes to chemotherapeutics, the recommendation is that breastfeeding should be avoided until the drug has been cleared from the milk [13]. In a case report of a 70 mg infusion of cisplatin, no detectable levels were found in milk after 66 hours [14], and in another case study using doxorubicin (trade name Adriamycin), no detectable levels were seen after 72 hours [15]. In our particular study, the subject was advised that breastfeeding could resume 12 days after each chemotherapy session.Here we present the first report on the effects of chemotherapy on microbial and metabolomic profiles in human milk over a 4-month period in a breastfeeding woman undergoing treatment for Hodgkin’s lymphoma (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Effect of chemotherapy on the microbiota and metabolome of human milk, a case report

et al. 2014

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BackgroundHuman milk is an important source of bacteria for the developing infant and has been shown to influence the bacterial composition of the neonatal gut, which in turn can affect disease risk later in life. Human milk is also an important source of nutrients, influencing bacterial composition but also directly affecting the host. While recent studies have emphasized the adverse effects of antibiotic therapy on the infant microbiota, the effects of maternal chemotherapy have not been previously studied. Here we report the effects of drug administration on the microbiota and metabolome of human milk.MethodsMature milk was collected every two weeks over a four month period from a lactating woman undergoing chemotherapy for Hodgkin’s lymphoma. Mature milk was also collected from healthy lactating women for comparison. Microbial profiles were analyzed by 16S sequencing and the metabolome by gas chromatography–mass spectrometry.FindingsChemotherapy caused a significant deviation from a healthy microbial and metabolomic profile, with depletion of genera Bifidobacterium, Eubacterium, Staphylococcus and Cloacibacterium in favor of Acinetobacter, Xanthomonadaceae and Stenotrophomonas. The metabolites docosahexaenoic acid and inositol known for their beneficial effects were also decreased.ConclusionWith milk contents being critical for shaping infant immunity and development, consideration needs to be given to the impact of drugs administered to the mother and the long-term potential consequences for the health of the infant.

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Section: Introductionmentioning

confidence: 99%

Effect of chemotherapy on the microbiota and metabolome of human milk, a case report

et al. 2014

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“…Plasma to milk transfer is highest during the first week of breast feeding due to the presence of larger gaps between the alveolar breast cells and the same might be true during the last part of breast feeding, when glandular involution occurs and milk amount decreases. Large molecules that have a high molecular weight, such as monoclonal antibodies (eg, IgG), hardly penetrate into human milk 17. Unlike many animal species, human IgG secreted in breast milk is not absorbed across the intestinal epithelium.…”

Section: Discussionmentioning

confidence: 99%

Persistent unilateral central serous chorioretinopathy in a breastfeeding woman

Lopez-Yang

Garcia

2015

BMJ Case Reports

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“…No data are however available concerning the ability of the immature liver to effectively degrade ingested molecules even if some reassuring data are available for thiopurine [ 14 ]. It is therefore advisable that women undergoing chemotherapy do not breastfeed their children [ 32 ]. It must be stressed, however, that this veto is only limited to the time during which medical treatment is administered.…”

Section: Breastfeedingmentioning

confidence: 97%