PMID- 32291564 OWN - NLM STAT- MEDLINE DCOM- 20201215 LR - 20210802 IS - 1932-2267 (Electronic) IS - 1932-2259 (Print) IS - 1932-2259 (Linking) VI - 14 IP - 4 DP - 2020 Aug TI - Breastfeeding practices among childhood cancer survivors. PG - 586-599 LID - 10.1007/s11764-020-00882-y [doi] AB - PURPOSE: This cross-sectional study compared breastfeeding outcomes among childhood cancer survivors to those of women in the general population and evaluated whether breastfeeding is adversely affected by cancer treatment or endocrine-related late effects. METHODS: A self-reported survey ascertained breastfeeding practices and incorporated items from the questionnaires used in the Infant Feeding Practices Study II (IFPS II) to allow comparison with the general population. Among 710 eligible survivors, 472 (66%) responded. The participants were predominantly non-Hispanic White (84%), married (73%), and had some college or less (60%). The mean maternal age at the time of birth of the first child after cancer treatment was 24 years (SD 24.3 +/- 4.8). RESULTS: Fewer survivors planned to breastfeed than did IFPS II controls (67% vs. 82%, P < .0001), and fewer survivors initiated breastfeeding (66% vs. 85%, P < .0001). The median breastfeeding duration was shorter among survivors, with early undesired weaning occurring sooner in the survivor group (1.4 months, interquartile range (IQR) 0.5-3.5 months) than in the IFPS II group (2.7 months, IQR 0.9-5.4 months). A higher proportion of survivors reported an unfavorable breastfeeding experience (19% vs. 7.5%, P < .0001) and early, undesired weaning (57.5%, 95% CI 51-64) than did IFPS II participants (45.2%, 95% CI 44-47, P = .0164). Among survivors who expressed intention and chose to breastfeed, 46% endorsed disrupted lactation related to physiologic problems with high risk in those overweight/obese. CONCLUSIONS: Survivors are at risk of negative breastfeeding experiences; however, lactation outcomes were not significantly associated with cancer diagnosis, treatments, or endocrine complications. IMPLICATIONS FOR CANCER SURVIVORS: Prior research has not examined the association of cancer treatments and clinically validated late effects with lactation outcomes in a clinically diverse childhood cancer survivor cohort. Findings from this study suggest that childhood cancer survivors, especially those who are overweight/obese, are at risk of having negative breastfeeding experiences. Early undesired weaning, physiologic problems related to lactation and misconceptions about breastfeeding, especially fears of passing on cancer through breastmilk, highlight the need for counseling and specialized support to optimize lactation outcomes in this vulnerable population. FAU - Ogg, Susan AU - Ogg S AD - Department of Nursing Research, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 738, Memphis, TN, 38015-2866, USA. susan.ogg@stjude.org. FAU - Klosky, James L AU - Klosky JL AD - Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, USA. AD - Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA. FAU - Chemaitilly, Wassim AU - Chemaitilly W AD - Department of Endocrinology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, USA. FAU - Srivastava, Deo Kumar AU - Srivastava DK AD - Department of Biostatistics, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, USA. FAU - Wang, Mingjuan AU - Wang M AD - Department of Biostatistics, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, USA. FAU - Carney, Ginger AU - Carney G AD - Department of Clinical Nutrition, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, USA. FAU - Ojha, Rohit AU - Ojha R AD - Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, USA. AD - JPS Health Network Center for Outcomes Research and the Department of Biostatistics and Epidemiology, UNT Health Science Center School of Public Health, Fort Worth, TX, USA. FAU - Robison, Leslie L AU - Robison LL AD - Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, USA. FAU - Cox, Cheryl L AU - Cox CL AD - Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, USA. FAU - Hudson, Melissa M AU - Hudson MM AD - Department of Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, USA. LA - eng SI - ClinicalTrials.gov/NCT02399956 GR - U01 CA195547/CA/NCI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20200414 PL - United States TA - J Cancer Surviv JT - Journal of cancer survivorship : research and practice JID - 101307557 SB - IM MH - Cancer Survivors/*statistics & numerical data MH - Cross-Sectional Studies MH - Female MH - Humans MH - Lactation/*physiology MH - Surveys and Questionnaires PMC - PMC7384306 MID - NIHMS1603525 OTO - NOTNLM OT - Breastfeeding OT - Cancer treatment OT - Childhood cancer survivors OT - Lactation OT - Late effects COIS- Conflict of Interest: The authors declare that they have no conflict of interest EDAT- 2020/04/16 06:00 MHDA- 2020/12/16 06:00 PMCR- 2021/08/01 CRDT- 2020/04/16 06:00 PHST- 2019/12/17 00:00 [received] PHST- 2020/03/28 00:00 [accepted] PHST- 2020/04/16 06:00 [pubmed] PHST- 2020/12/16 06:00 [medline] PHST- 2020/04/16 06:00 [entrez] PHST- 2021/08/01 00:00 [pmc-release] AID - 10.1007/s11764-020-00882-y [pii] AID - 10.1007/s11764-020-00882-y [doi] PST - ppublish SO - J Cancer Surviv. 2020 Aug;14(4):586-599. doi: 10.1007/s11764-020-00882-y. Epub 2020 Apr 14.