In special cases, women may be advised not to breastfeed. These instances include when a woman is taking certain medications or drugs, when she has been diagnosed with a specific illness, or when other specific conditions apply.
Medications/Other Drugs and Breastfeeding
Certain medications are known to be dangerous to infants and can be passed to your infant in your breast milk. Women taking the following medicines should not breastfeed and should speak with their health care providers before considering breastfeeding:
- Antiretroviral medications (for HIV/AIDS treatment)1
- Anxiety medications2
- Birth-control medications containing estrogen3
- Cancer chemotherapy agents1
- Illegal drugs1
- Migraine medications prescribed to treat migraines, such as ergot alkaloids4,5
- Mood stabilizers, such as lithium and lamotrigine4,6
- Sleep-aid medicines2
In addition, women who are undergoing radiation therapy should not breastfeed, although some therapies may require only a brief interruption of breastfeeding.1
The above list of medications and other drugs is only a guideline. Before breastfeeding, you should speak with your health care provider about all medications that you are taking.2 These include prescribed medications, over-the-counter medicines, vitamins, and herbal therapies.
Medications that are safe during pregnancy may also be safe for you to continue while you are breastfeeding, although you should check with your health care provider to make sure they are safe before you breastfeed.2
Contact your infant's health care provider if you see any signs of a reaction to your breast milk in your infant, such as diarrhea, excessive crying, or sleepiness.2
Health Conditions and Breastfeeding
Women with certain illnesses and infections may be advised not to breastfeed because of the danger of passing the illness or infection to the breastfed infant.
If you have any of the following conditions, speak with your health care provider before breastfeeding your infant:1,5
- Infection with human immunodeficiency virus (HIV)
- Infection with human T-cell lymphotropic virus type I or type II
- Untreated, active tuberculosis
If you are sick with the flu, including the H1N1 flu (also called the swine flu), you should not stop feeding your infant expressed milk. You should avoid being near your infant, however, so that you do not infect him or her. To avoid infecting your infant, someone who is not sick should give your infant your expressed milk.7
For more information on the flu, including the H1N1 flu, visit the following Centers for Disease Control and Prevention webpage: http://www.cdc.gov/flu/.
International Guidelines on HIV/AIDS and Breastfeeding
The potential for HIV transmission to an infant during breastfeeding has been known for some time. Recommending against breastfeeding is not a simple solution, however, because breastfeeding is beneficial to both a mother and her infant. Reducing HIV transmission, while simultaneously ensuring improved HIV-free infant survival, is one of the most pressing issues of HIV/AIDS research.8
World Health Organization (WHO) guidelines currently recommend that an HIV-infected mother who is breastfeeding should also take antiretroviral drugs, which help prevent HIV transmission to her infant. In addition, it is recommended that HIV-infected mothers breastfeed exclusively for 6 months, and continue thereafter up to 12 months while solid foods are introduced.9
Other Considerations and Breastfeeding
In some additional situations, or if women or infants have certain health conditions, women may be advised not to breastfeed or may have difficulty breastfeeding.4
- Women with certain chronic illnesses may be advised not to breastfeed, or will be advised to take steps to ensure their own health while breastfeeding. For example, women who have diabetes may need to eat slightly more food while they breastfeed to prevent their blood sugar levels from dropping. Also, women who are underweight, including those with thyroid conditions or certain bowel diseases, may need to increase their calories to maintain their own health during breastfeeding.
- Women who have had breast surgery in the past may face some difficulties with breastfeeding.
- Women who actively use drugs or do not control their alcohol intake, or who have a history of these situations, also may be advised not to breastfeed.
- Infants who have galactosemia—a rare metabolic disorder in which the body cannot digest the sugar galactose—should not be breastfed. Galactosemia is detected by newborn screening, allowing proper treatment and diet to begin immediately. If not detected, the galactose builds up and becomes toxic for the infant, leading to liver problems, intellectual and developmental disabilities, and shock.
- Centers for Disease Control and Prevention (CDC). (2009, October 20). Breastfeeding: Diseases and conditions. Retrieved April 27, 2012, from http://www.cdc.gov/breastfeeding/disease/index.htm [top]
- March of Dimes. (2011). Feeding your baby: Breastfeeding and medications, prescription drugs. Retrieved April 27, 2012, from http://www.marchofdimes.com/baby/feeding_medications.html [top]
- American College of Obstetricians and Gynecologists. (2011, May). Breastfeeding your baby. Retrieved April 27, 2012, from http://www.acog.org/~/media/For%20Patients/faq029.pdf?dmc=1&ts=20120427T1112598029 (PDF - 542 KB) [top]
- National Institute of Child Health & Human Development (NICHD). (2009, February 9). Breastfeeding. Retrieved April 27, 2012, from http://www.nichd.nih.gov/health/topics/Breastfeeding/ [top]
- Kelly Mom. (2011, Aug 1). Migraine medications and breastfeeding. Retrieved June 12, 2012, from http://kellymom.com/bf/can-i-breastfeed/meds/migraine-meds/ [top]
- Massachusetts General Hospital Center for Women's Mental Health. (n.d.). Breastfeeding & Psychiatric Medications.Retrieved June 12, 2012, from http://www.womensmentalhealth.org/specialty-clinics/breastfeeding-and-psychiatric-medication/ [top]
- CDC. (2009, October 23). 2009 H1N1 (swine flu) and feeding your baby: What parents should know. Retrieved April 27, 2012, from http://www.cdc.gov/h1n1flu/infantfeeding.htm [top]
- World Health Organization (WHO). (2008). HIV transmission through breastfeeding: A review of the available evidence. Retrieved April 27, 2012, from http://whqlibdoc.who.int/publications/2008/9789241596596_eng.pdf (PDF - 835 KB) [top]
- WHO. (2010). Guidelines on HIV and infant feeding. Retrieved April 27, 2012, from http://whqlibdoc.who.int/publications/2010/9789241599535_eng.pdf (PDF - 1.58 MB) [top]