Medical Contraindications to Breastfeeding in the United States

"A Review of the Medical Benefits and Contraindications to Breastfeeding in the United States" is a document prepared by Ruth Lawrence for the Maternal & Child Health care division of the Health Resources and Services Administration (HRSA}. The report was in response to requests from the US General Accounting Office that United States Department of Agriculture (USDA) and US Department of Health and Human Services (DHHS) have written policies defining the contraindications of breastfeeding.

Happily there are only 5 contraindications listed:
"HIV"
"HTLV-1"
mother taking "antimetabolite drugs"
mother taking "therapeutic doses of radio pharmaceuticals"
mother taking "drugs of abuse"

This is a US government publication and is free from:
National Maternal and Child Health Clearinghouse
2070 Chain Bridge Rd, Suite 450
Vienna, VA 22182-2536
(703) 356-1964
Fax (703) 821-2098

Other sources list a only few more conditions where caution is indicated:

"Infectious (contagious) tuberculosis: Breastfeeding is safe after the mother has undergone treatment and is no longer contagious.

Hepatitis A: Breastfeeding is safe after the mother receives a dose of gamma globulin.

Hepatitis B: Breastfeeding is safe after the baby receives a dose of Hepatitis B immune globulin (HBIG). The baby should also be started on the first of three doses of Hepatitis B vaccine.

Herpes simplex: Breastfeeding is safe if there are no lesions on the breast.

Chicken pox: Breastfeeding is safe as soon as the mother is noninfectious, meaning all spots are crusted over.

Lyme disease: Breastfeeding is safe as soon as the mother initiates treatment."

CMV (Cytomegalovirus): Low birth weight premature infants may have problems with CMV in their mother's milk and heat treatment and/or freezing and re-warming may help - very preliminary research on this.

Recommendations are often different in developing countries, where the risk of infant mortality is higher if the baby does not breastfeed.

Although certain prescribed drugs can preclude breastfeeding, the vast majority of moms on meds don't even need to interrupt breastfeeding. See Medications and Mothers' Milk.

If the mother has a common illnesses such as a cold or flu or mastitis she should continue to breastfeed her infant. Such illnesses are not passed through breast milk and breastfeeding continues to provide immunities to the infant.

references: Lawrence RA. A Review of the Medical Benefits and Contraindications to Breastfeeding in the United States (Maternal and Child Technical Information Bulletin). Arlington, VA:National Center for Education in Maternal and Child Health, Health Resources and Services Administration, 1997

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