When Not to Breastfeed: Safety Issues for You and Baby

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Breastfeeding continues to be touted as one of the healthiest things you can do for your newborn—but so is knowing when not to breastfeedBreast milk is natural, protective, custom-made for your baby and free. But there are times when a mother's breast milk could actually do more harm than good for her baby. 

Most often, it's because the mother has been diagnosed with a particular health condition that can be passed to the breastfed infant. Taking certain medications, particularly those that can be passed to your baby through your breastmilk, can also make nursing off-limits. 

Reasons Not to Breastfeed 

According to the Centers for Disease Control and Prevention, you should consult with your physician and stop breastfeeding if you...

  • Are infected with the human immunodeficiency virus (HIV)
  • Are taking antiretroviral medications
  • Have untreated, active tuberculosis (feeding expressed milk may still be safe)
  • Are infected with human T-cell lymphotropic virus type I or type II
  • Are using or are dependent upon an illicit drug
  • Are taking prescribed cancer chemotherapy agents, such as antimetabolites that interfere with DNA replication and cell division
  • Are undergoing radiation therapies, depending on what type of radiation is being used and what part of the body is being treated; consult a doctor

Meds That Don't Mix With Breastfeeding

Certain medications can pass through your breastmilk and put your infant in danger. Before taking any medication, let your health provider know if you are or plan to breastfeed. In addition to all illicit drugs, here are some common prescription drugs to avoid: 

  • Some anxiety medications
  • Birth-control pills containing estrogen
  • Antiretroviral medications (for HIV/AIDS treatment)
  • Cancer chemotherapy agents
  • Radiation therapy (some therapies may require only a brief interruption of breastfeeding)
  • Migraine medications (ergot alkaloids)
  • Mood stabilizers (lithium and lamotrigine)
  • Sleep aids

Health Conditions That May Interfere With Breastfeeding

If you or your newborn has been diagnosed with one of the following illnesses, consult your health care provider prior to breastfeeding. 

  • Diabetes. People with diabetes often need specialized dietary instructions to prevent blood sugar levels from dropping during breastfeeding, and may experience a delay in their milk coming in. However, breastfeeding increases insulin sensitivity and has long-term positive effects on glucose metabolism.
  • Thyroid conditions or certain bowel diseases that make you underweight. These conditions may require women to up their caloric intake to maintain their own health during breastfeeding.
  • Breast augmentation. Past breast surgery has been linked to breastfeeding difficulties.
  • Women with substance use issues (or a history of substance use) will likely be advised not to breastfeed.
  • Infants diagnosed with galactosemia, a rare metabolic disorder in which the body cannot digest the sugar galactose, should not be breastfed. 

Keep in mind that just because you're stopping now, it may not mean stopping forever. If your condition is temporary and you are able, you can always pump and dump your milk it to keep your milk production going. If your condition is more permanent and breastfeeding is an issue near and dear to you, consider getting donor milk from a milk bank.

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  1. Centers for Disease Control and Prevention. Contraindications to breastfeeding or feeding expressed breast milk to infants. Updated December 14, 2019.