Journal of Cancer Survivorship

, Volume 5, Issue 2, pp 175–181

Protective effects of breastfeeding for mothers surviving childhood cancer

  • Susan W. Ogg
  • Melissa M. Hudson
  • Mary E. Randolph
  • James L. Klosky



Female childhood cancer survivors experience adverse health events secondary to cancer treatment. In healthy women, breastfeeding provides protection against many of these complications. Breastfeeding may be beneficial for mothers surviving childhood cancer by decreasing risks of, or ameliorating adverse late effects. Healthcare providers and survivors should be aware that successful lactation may be affected by previous cancer treatment.


The literature addressing lactation outcomes in cancer patients is reviewed, and processes that may disrupt breastfeeding are discussed. A summary of common late effects experienced by women is provided, and arguments are made for the potential amelioration of these complications by breastfeeding.


Findings demonstrate that breastfeeding is beneficial for healthy mothers in regard to specific health conditions. There are limited data addressing breastfeeding outcomes among cancer survivors. Preliminary findings suggest that lactation is adversely affected among mothers treated for childhood cancer.


Fundamental research is needed to determine rates of breastfeeding in childhood cancer survivors, identify specific cancer therapies and their effects on lactation, examine the efficacy of breastfeeding in risk reduction and/or amelioration of late effects, and develop interventions to increase breastfeeding among survivors of childhood cancer.

Implications for cancer survivors

As female childhood cancer survivors transition into adult medical care, it is important each patient be aware of her past medical history and the impact of treatment on her ability to successfully lactate. If lactation is possible, these women can choose to breastfeed their children, thereby engaging in a health behavior that may help protect them against many late effects of cancer treatment.


Childhood cancer Survivorship Lactation Breastfeeding Late effects Prevention 


  1. 1.
    Ries L, Eisner MKC, et al. SEER cancer statistics review, 1975–2002. http://seercancergov/csr/1975_2002/2006 September 15
  2. 2.
    Hewitt M, Weiner S, Simone J. Childhood cancer survivorship: improving care and quality of life. Washington, DC: National Academies Press; 2003.Google Scholar
  3. 3.
    Lawrence RA, Lawrence RM. Breastfeeding: a guide for the medical profession. 6th ed. Elsevier Mosby; 2005.Google Scholar
  4. 4.
    Sklar CA. Growth and neuroendocrine dysfunction following therapy for childhood cancer. Pediatr Clin North Am. 1997;44(2):489–503.PubMedCrossRefGoogle Scholar
  5. 5.
    Hull KL, Harvey S. Growth hormone: roles in female reproduction. J Endocrinol. 2001;168(1):1–23.PubMedCrossRefGoogle Scholar
  6. 6.
    Merchant TE, Goloubeva O, Pritchard DL, Gaber MW, Xiong X, Danish RK, et al. Radiation dose-volume effects on growth hormone secretion. Int J Radiat Oncol Biol Phys. 2002;52(5):1264–70.PubMedCrossRefGoogle Scholar
  7. 7.
    Lustig RH, Schriock EA, Kaplan SL, Grumbach MM. Effect of growth hormone-releasing factor on growth hormone release in children with radiation-induced growth hormone deficiency. Pediatrics. 1985;76(2):274–9.PubMedGoogle Scholar
  8. 8.
    Schwartz CL. Long-term survivors of childhood cancer: the late effects of therapy. Oncologist. 1999;4(1):45–54.PubMedGoogle Scholar
  9. 9.
    Higgins S, Haffty BG. Pregnancy and lactation after breast-conserving therapy for early stage breast cancer. Cancer. 1994;73(8):2175–80.PubMedCrossRefGoogle Scholar
  10. 10.
    Tralins AH. Lactation after conservative breast surgery combined with radiation therapy. Am J Clin Oncol. 1995;18(1):40–3.PubMedCrossRefGoogle Scholar
  11. 11.
    Moran MS, Colasanto JM, Haffty BG, Wilson LD, Lund MW, Higgins SA. Effects of breast-conserving therapy on lactation after pregnancy. Cancer J. 2005;11(5):399–403.PubMedCrossRefGoogle Scholar
  12. 12.
    McCullough L, Ng A, Najita J, Janov A, Henderson T, Mauch P, et al. Breastfeeding in survivors of Hodgkin lymphoma treated with chest radiotherapy. Cancer. 2010;116(20):4866–71.PubMedCrossRefGoogle Scholar
  13. 13.
    Johnston K, Vowels M, Carroll S, Neville K, Cohn R. Failure to lactate: a possible late effect of cranial radiation. Pediatr Blood Cancer. 2008;50(3):721–2.PubMedCrossRefGoogle Scholar
  14. 14.
    American Academy of Pediatrics Policy Statement. Breastfeeding and the use of human milk. Pediatrics. 2005;115(2):496–506.CrossRefGoogle Scholar
  15. 15.
    Bener A, Denic S, Galadari S. Longer breast-feeding and protection against childhood leukaemia and lymphomas. Eur J Cancer. 2001;37(2):234–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Davis MK. Breastfeeding and chronic disease in childhood and adolescence. Pediatr Clin North Am. 2001;48(1):125–41. ix.PubMedCrossRefGoogle Scholar
  17. 17.
    Heinig MJ, Dewey KG. Health effects of breast feeding for mothers: a critical review. Nutr Res Rev. 1997;10(1):35–56.PubMedCrossRefGoogle Scholar
  18. 18.
    Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep) 2007 Apr;(153):1–186.Google Scholar
  19. 19.
    Castellino S, Hudson MM. Health issues in survivors of childhood cancer. South Med J. 2002;95(9):977–84.PubMedGoogle Scholar
  20. 20.
    Wasilewski-Masker K, Kaste SC, Hudson MM, Esiashvili N, Mattano LA, Meacham LR. Bone mineral density deficits in survivors of childhood cancer: long-term follow-up guidelines and review of the literature. Pediatrics. 2008;121(3):e705–13.PubMedCrossRefGoogle Scholar
  21. 21.
    Sowers M, Corton G, Shapiro B, Jannausch ML, Crutchfield M, Smith ML, et al. Changes in bone density with lactation. JAMA. 1993;269(24):3130–5.PubMedCrossRefGoogle Scholar
  22. 22.
    Polatti F, Capuzzo E, Viazzo F, Colleoni R, Klersy C. Bone mineral changes during and after lactation. Obstet Gynecol. 1999;94(1):52–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Cumming RG, Klineberg RJ. Breastfeeding and other reproductive factors and the risk of hip fractures in elderly women. Int J Epidemiol. 1993;22(4):684–91.PubMedCrossRefGoogle Scholar
  24. 24.
    Feldblum PJ, Zhang J, Rich LE, Fortney JA, Talmage RV. Lactation history and bone mineral density among perimenopausal women. Epidemiology. 1992;3(6):527–31.PubMedCrossRefGoogle Scholar
  25. 25.
    Siviero-Miachon AA, Spinola-Castro AM, Guerra-Junior G. Detection of metabolic syndrome features among childhood cancer survivors: a target to prevent disease. Vasc Health Risk Manag. 2008;4(4):825–36.PubMedGoogle Scholar
  26. 26.
    Garmey EG, Liu Q, Sklar CA, Meacham LR, Mertens AC, Stovall MA, et al. Longitudinal changes in obesity and body mass index among adult survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2008;26(28):4639–45.PubMedCrossRefGoogle Scholar
  27. 27.
    Armstrong GT, Sklar CA, Hudson MM, Robison LL. Long-term health status among survivors of childhood cancer: does sex matter? J Clin Oncol. 2007;25(28):4477–89.PubMedCrossRefGoogle Scholar
  28. 28.
    Brewer MM, Bates MR, Vannoy LP. Postpartum changes in maternal weight and body fat depots in lactating vs nonlactating women. Am J Clin Nutr. 1989;49(2):259–65.PubMedGoogle Scholar
  29. 29.
    Neville KA, Cohn RJ, Steinbeck KS, Johnston K, Walker JL. Hyperinsulinemia, impaired glucose tolerance, and diabetes mellitus in survivors of childhood cancer: prevalence and risk factors. J Clin Endocrinol Metab. 2006;91(11):4401–7.PubMedCrossRefGoogle Scholar
  30. 30.
    Stuebe AM, Rich-Edwards JW, Willett WC, Manson JE, Michels KB. Duration of lactation and incidence of type 2 diabetes. JAMA. 2005;294(20):2601–10.PubMedCrossRefGoogle Scholar
  31. 31.
    Stuebe AM, Michels KB, Willett WC, Manson JE, Rexrode K, Rich-Edwards JW. Duration of lactation and incidence of myocardial infarction in middle to late adulthood. Am J Obstet Gynecol. 2009;200(2):138.PubMedCrossRefGoogle Scholar
  32. 32.
    Schwarz EB, Ray RM, Stuebe AM, Allison MA, Ness RB, Freiberg MS, et al. Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol. 2009;113(5):974–82.PubMedGoogle Scholar
  33. 33.
    Gunderson EP, Jacobs Jr DR, Chiang V, Lewis CE, Feng J, Quesenberry Jr CP, et al. Duration of lactation and incidence of the metabolic syndrome in women of reproductive age according to gestational diabetes mellitus status: a 20-Year prospective study in CARDIA (Coronary Artery Risk Development in Young Adults). Diabetes. 2010;59(2):495–504.PubMedCrossRefGoogle Scholar
  34. 34.
    Meadows AT, Friedman DL, Neglia JP, Mertens AC, Donaldson SS, Stovall M, et al. Second neoplasms in survivors of childhood cancer: findings from the Childhood Cancer Survivor Study cohort. J Clin Oncol. 2009;27(14):2356–62.PubMedCrossRefGoogle Scholar
  35. 35.
    Kenney LB, Yasui Y, Inskip PD, Hammond S, Neglia JP, Mertens AC, et al. Breast cancer after childhood cancer: a report from the Childhood Cancer Survivor Study. Ann Intern Med. 2004;141(8):590–7.PubMedGoogle Scholar
  36. 36.
    Labbok MH. Effects of breastfeeding on the mother. Pediatr Clin North Am. 2001;48(1):143–58.PubMedCrossRefGoogle Scholar
  37. 37.
    Newcomb PA, Storer BE, Longnecker MP, Mittendorf R, Greenberg ER, Clapp RW, et al. Lactation and a reduced risk of premenopausal breast cancer. N Engl J Med. 1994;330(2):81–7.PubMedCrossRefGoogle Scholar
  38. 38.
    Zheng T, Duan L, Liu Y, Zhang B, Wang Y, Chen Y, et al. Lactation reduces breast cancer risk in Shandong Province, China. Am J Epidemiol. 2000;152(12):1129–35.PubMedCrossRefGoogle Scholar
  39. 39.
    Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002;360(9328):187–95.CrossRefGoogle Scholar
  40. 40.
    Stuebe AM, Willett WC, Xue F, Michels KB. Lactation and incidence of premenopausal breast cancer: a longitudinal study. Arch Intern Med. 2009;169(15):1364–71.PubMedCrossRefGoogle Scholar
  41. 41.
    Josephy PD. The role of peroxidase-catalyzed activation of aromatic amines in breast cancer. Mutagenesis. 1996;11(1):3–7.PubMedCrossRefGoogle Scholar
  42. 42.
    Schneider AP. Risk factor for ovarian cancer. N Engl J Med. 1987;317(8):508–9.PubMedCrossRefGoogle Scholar
  43. 43.
    Dickerman JD. The late effects of childhood cancer therapy. Pediatrics. 2007;119(3):554–68.PubMedCrossRefGoogle Scholar
  44. 44.
    Oeffinger KC, Hudson MM. Long-term complications following childhood and adolescent cancer: foundations for providing risk-based health care for survivors. CA Cancer J Clin. 2004;54(4):208–36.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Susan W. Ogg
    • 1
  • Melissa M. Hudson
    • 2
  • Mary E. Randolph
    • 1
  • James L. Klosky
    • 1
  1. 1.Department of PsychologySt. Jude Children’s Research HospitalMemphisUSA
  2. 2.Department of OncologySt. Jude Children’s Research HospitalMemphisUSA

Personalised recommendations