Contraindications to Breastfeeding

Rare times when breastfeeding in not recommended.

At a glance

Human milk provides the most complete form of nutrition for infants, including premature and sick newborns. However, in rare exceptions, human milk or breastfeeding is not recommended.

Mom and baby visiting with health care provider

What to know

Breastfeeding is the best source of nutrition for most infants. It can also reduce the risk for certain health conditions for both infants and mothers.

Physicians should make case-by-case assessments to determine if a woman should interrupt, stop, or never start breastfeeding due to an environmental exposure, medical condition, or infant's medical condition.

Reasons not to breastfeed

Mothers should not breastfeed or feed expressed breast milk to their infants if:

  • Their infant is diagnosed with classic galactosemia, a rare genetic metabolic disorder.1
  • They have HIV and:
    • Are not on HIV treatment (antiretroviral therapy or ART), or
    • Are on ART but have not achieved sustained viral suppression during pregnancy (at a minimum throughout the third trimester) or at the time of delivery. Women on ART should also not breastfeed if they are unable to maintain sustained viral suppression after giving birth.

If a mother with a detectable viral load chooses to breastfeed, the provider should remain engaged, offer guidance on antiretroviral (ARV) HIV prevention drugs and HIV testing for the infant, and assist the parent to rapidly regain and maintain viral suppression. Consult with an expert or the National Perinatal HIV/AIDS hotline (1-888-448-8764).

Mothers with HIV:‎

Mothers with HIV who have questions about breastfeeding should receive patient-centered, evidence-based counseling about infant feeding options and be supported in their decision. Learn more.
  • They are infected with human T-cell lymphotropic virus type I or type II (HTLV – 1/2).1
  • They are using an illicit drug, such as opioids, PCP (phencyclidine) or cocaine.2 For mothers who discontinue illicit opioids or other substances and are on stable methadone or buprenorphine maintenance therapy, breastfeeding should be encouraged.
  • They have suspected or confirmed Ebola virus disease.

Reasons to temporarily stop breastfeeding

Mothers should temporarily not breastfeed or feed expressed breast milk to their infants if:

  • They are taking certain medications.12
  • They are undergoing diagnostic imaging with radiopharmaceuticals (drugs that emit radiation).2
  • They have an active herpes simplex virus (HSV) infection with lesions (sores) present on the breast.3 (Note: Mothers can breastfeed directly from the unaffected breast if lesions on the affected breast are covered completely).
  • They have mpox virus infection (Note: breastfeeding should be delayed until criteria for discontinuing isolation have been met, including all lesions have resolved, the scabs have fallen off, and a fresh layer of intact skin has formed.

When to resume breastfeeding‎

Mothers may be able to resume breastfeeding after consulting with a physician to determine when their breast milk is safe for their infant. These mothers can receive breastfeeding support to learn how to maintain milk production and feed their infants. While not breastfeeding temporarily, feeding options include pasteurized donor human milk, previously expressed breast milk (if appropriate), or formula.

Mothers should temporarily not breastfeed, but can feed expressed breast milk if:

  • They have untreated, active tuberculosis.
    • Note: The mother may resume breastfeeding once she has been treated appropriately for 2 weeks. In addition, a doctor must document that she is no longer contagious.
  • They have an active varicella (chicken pox) infection that developed between 5 days before delivery and 2 days following delivery.

Temporary separation considerations ‎

If an infection is spread through the air or by contact, precautions may require temporary separation of the mother and infant. During this time, expressed breast milk should be given to the infant by another care provider. Mothers should be able to resume breastfeeding after consulting with a physician to determine when there is no longer a risk of spreading infection. These mothers should receive lactation support to learn how to maintain milk production while not breastfeeding and/or while expressing their milk.

Taking medications while breastfeeding

There are few medications that you cannot take while breastfeeding. Although many medications pass into breast milk, most have no known adverse effect on milk supply or infant well-being. However, healthcare providers should always weigh the risks and benefits when prescribing medications to women who are breastfeeding.

Learn more about safe prescription medication use while breastfeeding.

Review the most up-to-date information available on medications and lactation on LactMed®.

Learn more

  1. Meek JY, Noble L. American Academy of Pediatrics policy statement: Breastfeeding and the use of human milk. Pediatrics. 2022;150 (1): e2022057988. 10.1542/peds.2022-057988.
  2. Sachs HC. The transfer of drugs and therapeutics into human breast milk: An update on selected topics. Pediatrics. 2013;132(3):e796-e809.
  3. Berens P, Eglash A, Mallow M, Steube AM. Protocol #26: Persistent pain with breastfeeding. Breastfeeding Medicine. 2016;11(2):1-8.