Parenting

What it’s like to breastfeed after you have a mastectomy


I couldn’t freeze my eggs and no one on my medical team could tell me how my fertility would be affected (Picture: Joana Cerqueira)

I always wanted children.  

Coming from a Portugese background that’s very family-orientated, I’d always been maternal – the mother hen of my friendship group.

Having a family of my own was really, really important – and I had naturally assumed breastfeeding would be a part of that.  

But then, when I was 26, I was diagnosed with stage three breast cancer and scheduled for a mastectomy three weeks later. 

Looking back, I was very naive. I don’t think I fully understood the severity of what the doctors had said to me.

I felt sad, I cried, and I went through a ‘why me’ phase – but it was very short. It wasn’t important to me why I had got cancer, only the decisions and steps I needed to make to get better. 

It helped that I had a new relationship to focus on.

James and I had our first date the day before my diagnosis but by the time my surgery came around, we were already serious about one another. 

Making the decision about having a mastectomy and losing my breast was devastating.  Although I had a reconstruction, I felt like I lost half of what made me a woman. 

Particularly being in a new relationship, I was worried about what it would mean.  Would I still be me?  

I remember asking about breastfeeding even then – would it even be possible to feed a child with one breast? The doctors tried to be positive, but the truth was they simply didn’t know.  

Worse was to come, however. With my breast gone, I was prescribed a four month course of chemotherapy and put on hormone therapy medication, called tamoxifen.

I couldn’t freeze my eggs and no one on my medical team could tell me how my fertility would be affected by the time I finished all the drugs. 

Then, in October 2015, three years after my mastectomy and initial treatment the cancer came back.

Joana breastfeeding her son Javier (Picture: Sophie Darwin Photography)

I underwent a lumpectomy and a round of radiotherapy, and was put on a five-year course of even stronger hormone therapy medication, this time in the form of injections that effectively told my body to stop ovulating.  

It was even harder than the first time around. James and I had already waited so long to start a family only to be told no, yet again.

I knew I couldn’t wait another five years to even start trying to get pregnant. Friends were already having their second and third children.

When my best friend told me she was pregnant, I bawled my eyes out, not because I wasn’t happy for her, but because I so desperately wanted what she had. And, yet again, cancer had got in the way. 

We had no option but to be patient, and my doctors at least agreed to reduce the course of injections from five years to two – and when it finally finished, despite there being no guarantees, James and I started trying for a baby almost straight away. 

My first period came that July, and the second in early August, and I conceived later that month. I simply couldn’t believe it. I took a test at six am before work and was shocked when two lines appeared. 

I then did three further tests just to be sure. 

Despite the hospital keeping a close eye on me, I had a healthy pregnancy and, throughout, breastfeeding remained one of my priorities.  

I asked everyone about it: my consultant, my midwives – even my hypnobirthing group. But just like when I’d had cancer the first time, there were no clear answers.

My consultant said that it should be possible to feed with one breast but that my body was unlikely to produce enough milk, and I would have to use formula to top up my feeds. 

The midwives were more positive. They felt that there wasn’t any reason why I couldn’t feed on just one side; my body would produce what my baby needed, and they equated it to having twins.

My son, Javier, was born on 28 May 2019 (Picture: Joana Cerqueira)

I had never thought about it that way – I had always thought that I was abnormal for only having one breast. 

My son, Javier, was born on 28 May 2019 and I started feeding him about an hour after he was born as I lay in the recovery room after a caesarean.   

I produced colostrum (the thick, concentrated substance produced before milk) easily and Javier seemed happy. I never felt that he wanted extra feeds, or that I needed to give him formula.

By day two, my milk came in and by the third day he was cluster feeding – when babies eat more frequently – throughout the night. 

It wasn’t always straightforward. Only having one breast with which to feed him meant I had no respite. It really took its toll on my nipple.

During a visit to a breastfeeding clinic, the nurse was aghast at how red and sore it was.  

But I just kept on going. I think I have always been quite determined and yes, it was painful, but I don’t think my breastfeeding experience was any worse than anyone else’s.

There had been no guarantees that I’d be able to nurse my baby – but breastfeeding is uncertain for everyone, even if you’re healthy. 

In fact, I felt incredibly proud that I was able to do it. I was really proud of my body, too, for getting me through pregnancy, and that it wanted to produce milk for my baby. 

Looking down at my son as he fed, even at 3am, the bond was incredible.  

I think there was a part of me that saw having children as a way of saying to the cancer that it hadn’t beaten me or stopped me doing what I wanted with my life.  

I’m a cancer patient and will always be, but this disease hasn’t stopped me moving forward. Breastfeeding was a huge part of that. It was like showing the world what’s really important to me. 

Javier is now 14 months old and I am still breastfeeding him. It feels like it’s what he needs from me, and my mindset has switched. Initially, I suspect that I was breastfeeding to prove something, at least to myself.  Now, I do it because it feels natural, my son loves it and I love it.

I haven’t been given the all-clear from cancer as such but I haven’t had a recurrence for two years and that’s a positive sign. 

James and I are definitely thinking about having more children. I feel so much more confident knowing what my body can do.

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