Contraindications to Breastfeeding or Feeding Expressed Breast Milk to Infants

• Infant is diagnosed with classic galactosemiaexternal icon, a rare genetic metabolic disorder¹
• Mother has HIV and 1) is not on antiretroviral therapy (ART), or 2) is on ART but has not achieved sustained viral suppression during pregnancy (at a minimum throughout the third trimester) or at the time of delivery, or is unable to maintain sustained viral suppression postpartum. If a mother with a detectable viral load chooses to breastfeed, the provider should remain engaged, offer guidance on ARV prophylaxis and HIV testing for the infant, and assist the parent to rapidly regain and maintain virologic suppression. Consultation with an expert or the National Perinatal HIV/AIDS hotline (1-888-448-8764) is recommended.
• Mother is infected with human T-cell lymphotropic virus type I or type II (HTLV – 1/2)¹
• Mother is using an illicit drug, such as opioids, PCP (phencyclidine) or cocaine⁴ (For mothers who discontinue illicit opioids or other substances and are on stable methadone or buprenorphine maintenance therapy, breastfeeding should be encouraged.)
• Mother has suspected or confirmed Ebola virus disease

• Mother is infected with untreated brucellosis¹
• Mother is taking certain medications^1,2
• 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)
• Mother has mpox virus infection (Note: breastfeeding should be delayed until criteria for discontinuing isolation have been met (i.e., all lesions have resolved, the scabs have fallen off, and a fresh layer of intact skin has formed)⁵.

• Mother has untreated, active tuberculosis⁴
  (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 (chicken pox) infection that developed within the 5 days prior to delivery to the 2 days following delivery⁴

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®.