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Breastfeeding Contraindications WIC Policy & Procedures Manual POLICY: NED: 06.00.00 Page 1 of 1 Subject: Breastfeeding Contraindications Effective Date: October 1, 2019 Revised from: October 1, 2015 Policy: There are very few medical reasons when a mother should not breastfeed. Identify contraindications that may exist for the participant. Breastfeeding is contraindicated when: • The infant is diagnosed with classic galactosemia, a rare genetic metabolic disorder. • Mother has tested positive for HIV (Human Immunodeficiency Syndrome) or has Acquired Immune Deficiency Syndrome (AIDS). • The mother has tested positive for human T-cell Lymphotropic Virus type I or type II (HTLV-1/2). • The mother is using illicit street drugs, such as PCP (phencyclidine) or cocaine (exception: narcotic-dependent mothers who are enrolled in a supervised methadone program and have a negative screening for HIV and other illicit drugs can breastfeed). • The mother has suspected or confirmed Ebola virus disease. Breastfeeding may be temporarily contraindicated when: • The mother is infected with untreated brucellosis. • The mother has an active herpes simplex virus (HSV) infection with lesions on the breast. • The mother is undergoing diagnostic imaging with radiopharmaceuticals. • The mother is taking certain medications or illicit drugs. Note: mothers should be provided breastfeeding support and a breast pump, when appropriate, and may resume breastfeeding after consulting with their health care provider to determine when and if their breast milk is safe for their infant and should be provided with lactation support to establish and maintain milk supply. Direct breastfeeding may be temporarily contraindicated and the mother should be temporarily isolated from her infant(s) but expressed breast milk can be fed to the infant(s) when: • The mother has untreated, active Tuberculosis (TB) (may resume breastfeeding once she has been treated approximately for two weeks and is documented to be no longer contagious). • The mother has active varicella (chicken pox) infection that developed within the five days prior to delivery to the two days following delivery. Note: mothers should be provided breastfeeding support and a breast pump, when appropriate. WIC Policy & Procedures Manual POLICY: NED: 06.00.00 Page 2 of 2 Subject: Breastfeeding Contraindications Procedure: 1. When a client has a condition that contraindicates breastfeeding, encourage them to change their behavior (alcohol and/or drug use), receive medical treatment or, in the case of some medical conditions, avoid breastfeeding altogether. a. For AIDS/HIV • Advise all clients to know their HIV status and receive early diagnosis through routine, voluntary testing. • Respect client’s confidentiality and do not ask their HIV status. • Counsel all clients that HIV positive women should not breastfeed. • Provide referrals to appropriate health care and supportive services. For the most current management recommendations, contact the HIV/AIDS Treatment Information Service at 1-800-448-0440. b. For drug or alcohol abuse • Advise women to avoid drug and alcohol use while breastfeeding. Inform them that alcohol and many drugs, including prescription, over-the-counter, herbal supplements, marijuana and other illegal drugs, can pass into breast milk and harm the baby. • If a woman is using marijuana, illegal drugs, alcohol or other substances, warn of the dangers and make a referral for further assistance. • Women who want to breastfeed should be counseled to avoid drinking alcohol. Generally, moderate alcohol consumption (up to 1 standard drink per day) by a breastfeeding mother is not known to be harmful to the infant. It is advised that she not breastfeed for at least 2 hours after a single drink while nursing. See the Nutrition Risk Factor Manual for the definition of the risk factor for breastfeeding women – Alcohol and Substance Use. • Advise women to inform their healthcare providers that they are breastfeeding, so medications can be prescribed that are not contraindicated. c. For women who have conditions listed in the policy- counsel on appropriate breastfeeding recommendations. WIC Policy & Procedures Manual POLICY: NED: 06.00.00 Page 3 of 3 Subject: Breastfeeding Contraindications 2. Communicate the risks involved to the participant/infant if they breastfeed with any of the above conditions. 3. For more information: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/index.html .
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