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Contraindications to Breastfeeding or Feeding Expressed Breast Milk to Infants

While human milk provides the most complete form of nutrition for infants, including premature and sick newborns, there are rare exceptions when human milk or breastfeeding is not recommended. Additional information about these conditions is available by clicking the links provided.

Contraindications to Breastfeeding or Feeding Expressed Breast Milk to Infants

Physicians should make case-by-case assessments to determine whether a woman’s environmental exposure, her own medical condition, or the medical condition of the infant warrants her to interrupt, stop, or never start breastfeeding.

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

  • Infant is diagnosed with classic galactosemia, a rare genetic metabolic disorder1
  • Mother is infected with the human immunodeficiency virus (HIV)1 (Note: recommendations about breastfeeding and HIV may be different in other countries)
  • Mother is infected with human T-cell lymphotropic virus type I or type II [PDF-805KB] (HTLV – 1/2)1
  • Mother is using an illicit street drug, such as PCP (phencyclidine) or cocaine1 (Exception: Narcotic-dependent mothers who are enrolled in a supervised methadone program and have a negative screening for HIV infection and other illicit drugs can breastfeed)
  • Mother has suspected or confirmed Ebola virus disease

Mothers should temporarily NOT breastfeed and should NOT feed expressed breast milk to their infants if

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 should be provided with lactation support to learn how to maintain milk production and feed their infants with pasteurized donor human milk or formula while temporarily not breastfeeding.

  • Mother is infected with untreated brucellosis1
  • Mother is taking certain medications1,2
  • The mother is undergoing diagnostic imaging [PDF-778KB] with radiopharmaceuticals2
  • Mother has an active herpes simplex virus (HSV) infection with lesions present on the breast3 (Note: Mothers can breastfeed directly from the unaffected breast if lesions on the affected breast are covered completely to avoid transmission)

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 should be provided with lactation support to learn how to maintain milk production and feed their infants with pasteurized donor human milk or formula while temporarily not breastfeeding.

Mothers should temporarily NOT breastfeed, but CAN feed expressed breast milk if

Airborne and contact precautions may require temporary separation of the mother and infant, during which 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 be provided with lactation support to learn how to maintain milk production while not breastfeeding and/or while expressing their milk.

  • Mother has untreated, active tuberculosis1
    (Note: The mother may resume breastfeeding once she has been treated appropriately for 2 weeks and is documented to be no longer contagious)
  • Mother has active varicella [PDF-805KB] (chicken pox) infection that developed within the 5 days prior to delivery to the 2 days following delivery1

Airborne and contact precautions may require temporary separation of the mother and infant, during which 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 be provided with lactation support to learn how to maintain milk production while not breastfeeding and/or while expressing their milk.

Are medications safe to take while breastfeeding?

Few medications are contraindicated while breastfeeding. Although many medications do pass into breast milk, most have no known adverse effect on milk supply or on infant well-being. However, healthcare providers should always weigh the risks and benefits when prescribing medications to breastfeeding mothers.

Learn more about safe prescription medication use while breastfeeding.

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

Sources

  1. Eidelman AI, Schanler RJ; Section on Breastfeeding. (2012). American Academy of Pediatrics Policy Statement: Breastfeeding and the Use of Human Milk [PDF-805KB]. Pediatrics, 129(3):e827-e841.
  2. American Academy of Pediatrics Committee on Drugs. (2013). The Transfer of Drugs and Therapeutics Into Human Breast Milk: An Update on Selected Topics [PDF-767KB]. Pediatrics, 132(3):e796-e809.
  3. Academy of Breastfeeding Medicine. (2016). Protocol #26: Persistent Pain with Breastfeeding. Breastfeeding Medicine, 11(2):1-8.

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