Breastfeeding Promotion and Support (BF) BF-8 Breastfeeding Contraindications 1

Maine Center for Disease Control and Prevention WIC Nutrition Program Effective: October 1, 2011 Policy No. BF-8 Revised: October 1, 2022

Contraindications for Breastfeeding Authority 7 CFR Part 246.11(c)(7) and (e)(1) 22 MRSA §255 and §1951 American Academy of Pediatrics, Pediatric Nutrition Handbook, 7th Edition, 2013 American Academy of Pediatrics, Policy Statement Breastfeeding and the Use of Human Milk (Pediatrics Vol.129 No.3 March 01, 2012)

Policy 1. Breast/chestfeeding contraindications shall follow evidence-based recommendations from the American Academy of Pediatrics.

Procedure 1. Breastfeeding and chestfeeding are contraindicated for an infant diagnosed with galactosemia, a rare genetic metabolic disorder. 2. Breast/chestfeeding is contraindicated for an infant whose lactating parent: 2.1 Is infected with the human immunodeficiency virus (HIV) 2.2 Has active tuberculosis or brucellosis (breast/chestfeeding can resume after a minimum of two weeks of tuberculosis treatment and parent is documented to no longer be infectious) 2.3 Is infected with human T-cell lymphotropic virus type I or type II 2.4 Has an active herpes lesion or open sore on their breast (lactating parent may feed baby pumped milk from this breast or may breastfeed from the unaffected side) 2.5 Is receiving prescription medication from the following classes of substances: chemotherapy agents; amphetamines; ergotamines; statins 3. Refer participants with the following conditions to a medical provider for guidance on when to resume breast/chestfeeding after treatment: 3.1 Hepatitis A: As soon as mother receives gamma globulin

Breastfeeding Promotion and Support (BF) BF-8 Breastfeeding Contraindications 2

3.2 Hepatitis B: After infant receives HBIG, first dose of hepatitis B vaccine should be given before hospital discharge 3.3 Hepatitis C: If no co-infections exist 3.4 Lyme disease: As soon as lactating parent begins treatment 3.5 Active TB: After lactating parent has received 2 or more weeks of treatment 3.6 Varicella-zoster (chicken pox): As soon as lactating parent becomes noninfectious 3.7 Antimetabolite chemotherapy: Depending on type of therapy, breast/chestfeeding may be contraindicated 3.8 Drug Abuse: Lactating parents ingesting drugs of abuse shall not breast/chestfeed until they are free of the abused drugs or undergo appropriate treatment and counseling. 3.9 Elevated Blood Lead Levels: May require pumping/discarding their milk for a brief period of time until their lead levels return to an acceptable range. 4. For additional information on contraindications to breast/chestfeeding see Appendix BF-8-A AAP Statement: Breastfeeding and the Use of Human Milk. 5. For an updated listing of medications and drugs that are contraindicated during breastfeeding, refer to Thomas Hale’s Sixteenth Edition of Medications and Mothers’ Milk or search electronically in the LactMed database: http://toxnet.nlm.nih.gov/