Breast milk is best for babies for many reasons, and there are only a few reasons why mom’s own milk cannot be used.
When Breast Milk Cannot be Used:
- Maternal HIV infection
- Maternal Human T-Lymphocyte Virus infection (HTLV 1 or 2)
- Certain medicines or therapies: chemotherapy, radioactive isotopes, radiation therapy, antimetabolites, antiretroviral medications
- Active herpetic lesions of both nipples
- Active maternal use of drugs or abuse (including heroin, cocaine, methamphetamine)
- Abuse of prescription drugs or opioid use without prescription
- Heavy use/abuse of benzodiazepines
- Heavy maternal alcohol use
- Infant diagnosis of classic galactosemia
Pumping Instead of Breastfeeding
In the following situations, mothers may not put their infant directly to the breast, but may pump and give their breast milk via bottle:
- Active untreated tuberculosis (until mom has a documented negative sputum and has received 2 weeks of therapy)
- Active varicella infection (chickenpox), unless there are varicella lesions on the nipple
- Herpetic lesions on the breast, but not the nipple (see above)
- Active maternal influenza or COVID-19 infection (direct breastfeeding may continue after mom has received 48 hours of anti-viral therapy and is 24 hours without a fever)
THC, a compound found in marijuana, can pass into breast milk and may permanently harm your baby’s developing brain. Because of these potential risks, UAMS advises that you do NOT use marijuana/cannabis, in any form, while providing breast milk to your baby.
Cases When Moms Can Breastfeed
The following conditions are NOT reasons moms cannot or should not breastfeed or give expressed breast milk via bottle.
- Maternal Hepatitis B infection
- Maternal Hepatitis C infection *Mothers with HCV and bleeding nipples should try to avoid feeding the affected milk. There is not enough evidence for us to be sure that there is no risk of transmission to baby through the milk.
- Maternal CMV infection
- Herpes not affecting the breast/nipple; lesions should be covered and proper hand hygiene performed before touching the baby
- Mastitis or breast abscess (unless the nipple is involved)
- Maternal illness: fever, URI, sore throat, GI infection
- Poor maternal nutrition
- Tobacco use (though we strongly recommend that you stop smoking)
- The use of electronic nicotine (e-cigs or vape) is not considered safer
- The use of nicotine replacement therapy (gum, patches, etc) is safer but should be discussed with a Breastfeeding Medicine Specialist.
- If the baby is exposed to nicotine prenatally, through breastmilk and/or secondhand smoke, there is a greater risk of SIDS and permanent damage to lung/brain development.
- Occasional alcohol (for an occasional drink, we recommend pumping/feeding just prior to the drink, then waiting 3-4 hours before pumping/feeding again)
- Methadone, buprenorphine (e.g., Suboxone, Subutex) or other chronic narcotic use under physician supervision (providing breast milk may help with neonatal withdrawal)
- Limited use of postoperative pain medications
- Breast reduction or augmentation
- Nipple piercings (though any rings/objects should be removed before breastfeeding or pumping)
- Administration of contrast media (please see separate handout for additional information)
Most medications are safe during breastfeeding, but we encourage you to ask a lactation specialist about any medications or supplements you are taking (prescription or over-the-counter) to be sure there are no reasons to avoid using breast milk. Please call your doctor if you have questions, if you are unsure about the safety of the medications you are currently taking, or if you begin taking a new medication while breastfeeding.
Please visit The AAP (American Acadmey of Pediatrics) Parenting Website or the CDC( Center for Disease Control and Prevention) for more informtaion.