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.
- Infant is diagnosed with classic galactosemiaexternal icon, 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 icon[PDF-805KB]external icon (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
- Mother is infected with untreated brucellosis1
- Mother is taking certain medications1,2
- The mother is undergoing diagnostic imaging pdf icon[PDF-778KB]external icon 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)
- 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 icon[PDF-805KB]external icon (chicken pox) infection that developed within the 5 days prior to delivery to the 2 days following delivery1
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®external icon.
- Eidelman AI, Schanler RJ; Section on Breastfeeding. (2012). American Academy of Pediatrics Policy Statement: Breastfeeding and the Use of Human Milk pdf icon[PDF-805KB]external icon. Pediatrics, 129(3):e827-e841.
- American Academy of Pediatrics Committee on Drugs. (2013). The Transfer of Drugs and Therapeutics Into Human Breast Milk: An Update on Selected Topics pdf icon[PDF-767KB]external icon. Pediatrics, 132(3):e796-e809.
- Academy of Breastfeeding Medicine. (2016). Protocol #26: Persistent Pain with Breastfeedingexternal icon. Breastfeeding Medicine, 11(2):1-8.
- American Academy of Pediatrics. Red Book Online, 2015.external icon
- American Academy of Pediatrics. (2013). Policy Statement: Infant Feeding and Transmission of Human Immunodeficiency Virus in the United States.external icon Pediatrics, 131(2):391-396.