Contraindications to breastfeeding or feeding expressed breast milk to infants

Do not breastfeed and do not feed expressed breast milk
Infant has classic galactosemia (ie, not Duarte variant)	These conditions preclude breastfeeding.
Mother has HIV infection*
Mother is infected with HTLV I or II
Mother is using illicit drugs (eg, phencyclidine or cocaine)^¶
Mother has suspected or confirmed Ebola virus disease
Temporarily do not breastfeed and do not feed expressed breast milk
Mother has untreated brucellosis	Mothers may be able to resume breastfeeding after consulting with a clinician 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 taking certain medications^Δ^◊
Mother has an active HSV infection, with lesions present on the breast^§
Temporarily do not breastfeed, but may feed expressed breast milk to infant
Mother has untreated active tuberculosis^¥	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 clinician 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 active varicella that developed between 5 days prior to delivery and 2 days following delivery

While human milk provides the most complete form of nutrition for infants, including premature and sick newborns, there are rare exceptions when human milk/breastfeeding is not recommended, as outlined in this table.

HTLV: human T-lymphotropic virus; HSV: herpes simplex virus.
* This recommendation is for women in the United States and other resource-rich countries. Breastfeeding by HIV-infected women may be appropriate in resource-limited settings if breast milk replacement is not feasible, affordable, or safe^[1].
¶ Narcotic-dependent women who are in a supervised methadone program or buprenorphine program with negative screening for HIV and other illicit drugs may breastfeed^[1].
Δ Most, but not all, therapeutic drugs are compatible with breastfeeding^[1]. Medications should be reviewed on a case-by-case basis for potential contraindications. The LactMed database, produced by the National Library of Medicine, is a free authoritative reference for lactation compatibility for prescription and over-the-counter drugs. This resource provides data on drug levels in human milk and infant serum, potential adverse effects on breastfeeding infants and lactation, and recommendations for alternative drugs.
◊ Breastfeeding should be suspended during and after administration of certain radiopharmaceutical drugs. The recommended suspension of breastfeeding varies depending on the radioactive compound. Compounds used for tumor and cardiac imaging usually require prolonged cessation of breastfeeding^[2].
§ Mothers breastfeed directly from the unaffected breast if lesions on the affected breast are covered completely and with good handwashing to avoid transmission.
¥ The mother may resume breastfeeding once she has been treated appropriately for 2 weeks and is documented to be no longer contagious^[1].

References:

Johnston M, Landers S, Noble L, et al. Breastfeeding and the use of human milk. Pediatrics 2012; 129:e827.
Sachs HC, Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics 2013; 132:e796.

Modified from: Centers for Disease Control and Prevention. Breastfeeding: Contraindications to Breastfeeding or Feeding Expressed Breast Milk to Infants. Available at: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/contraindications-to-breastfeeding.html (Accessed on July 31, 2020).

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Contraindications to breastfeeding or feeding expressed breast milk to infants