Reasons NOT to breastfeed

Dr. Alexandra Prosser
Jan 29, 2023
2 min read

Wha!? I thought you were here to promote breastfeeding!

Yes, I am. I am here to promote safe breastfeeding.

There are only a few reasons why a physician would advise you NOT to breastfeed, either altogether or only temporarily. As always, and reiterated below, please consult with your physician and/or lactation counselor for personalized advice and support.

Contraindications to Breastfeeding

According to the CDC, there are only five medical conditions that make breastfeeding dangerous, and thus NOT recommended :

Infant galactossemia
Human T Cell Lymphotropic Virus (HTLV)
Illicit Drugs*
Ebola
HIV**

*A mother can be permitted to breastfeed if she is enrolled in a methadone or buprenorphine supervised program, as long as she tests negative for HIV and other illicit drugs. In fact, in these circumstances, breastfeeding the infant immediately postpartum helps baby "self-wean" off opiates in a more comfortable manner.

**Historically, US physicians recommend against breastfeeding if mother is HIV positive. The risks of transmitting HIV to the baby were too high. However, there is new research that pregnant women who are HIV-positive, on treatment, and with low CD4 cell counts, can breastfeed safely with very low chance of transmitting the virus to their baby. If this applies to you, please discuss with your physicians.

When should I avoid nursing and give pumped milk instead?

According to the CDC, there are only two reasons to temporarily stop nursing. During this time, it is still safe to pump and give that milk to the infant.

Untreated, active tuberculosis
Active varicella (chicken pox), that developed within 5 days prior to delivery or within 2 days after delivery.

Whenever you have a concern about possibly spreading an infection to your infant, please contact your primary care physician or lactation counselor. They can help you determine if you need to temporarily avoid nursing, and they can provide guidance for ensuring adequate milk supply while "away" from your baby.

When should I temporarily avoid nursing and giving expressed milk?

Again, there are only a few circumstances in which we recommend against giving breastmilk to baby. During this time, you may give breastmilk that you pumped before, donated breastmilk, or infant formula.

Untreated brucellosis
Radioactive medicines or nuclear imaging
Human simplex virus (HSV) on the breast

Note that CT, MRI, and XRay imaging are still safe. Please consult with your physician and your baby's physician to see when it is safe to resume giving breastmilk, either by nursing or pumped milk.

Are there any medicines that are unsafe to take while breastfeeding?

Yes, however there are not as many as you may think. Most medications can be safely taken while breastfeeding. Stay tuned for another blog post for specifics. If you have questions about a particular medicine, reliable evidence-based resources are available at