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Breastfeeding has many health-promoting effects, especially during the first six months, on both the mother and the newborn. It may help reduce the risk of acute infections in mothers such as pneumonia and diarrhoea and also protects against chronic diseases such as diabetes and hypertension. In newborns, breast milk promotes healthy development and lower the risk of a range of diseases.
According to studies, breastfeeding is the foremost nutrition for babies, until there is a medical condition existing on the mother or infant side. If a medical condition is present in mothers, breastfeeding is temporarily or permanently halted and replaced with breast-milk substitutes, to prevent the risk of other serious conditions. 
In this article, we will discuss some of the medical and non-medical conditions in which breastfeeding should be avoided permanently, temporarily or temporarily while feeding expressed breast milk.
Remember, whenever a doctor advises a mother to stop or pause breastfeeding, it is because the benefits of breastfeeding are weighted less compared to the risk of diseases it can cause later.
Conditions In Which Mothers Should Permanently Avoid Breastfeeding
1. HIV infection
According to the WHO, the general range of HIV transmission through any kind of breastfeeding without any interventions is 5-20 per cent. The HIV-infected mothers who are treated with combined antiretroviral therapy can breastfeed their child for 12-24 months.
Also, women who are still under antiretrovirals are more likely to transmit HIV through breastfeeding. It is good to consult medical experts to understand more about HIV and breastfeeding. 
2. Ebola virus disease
A study has shown that the presence of Ebola virus diseases in breast milk can cause a potential risk of transmission of the virus to infants through breastfeeding. The study adds that infants who were fed breast milk by Ebola positive mothers have died later and the virus was detected in their tears, sweat, saliva and contaminated surfaces.
Therefore, the certainty of the route of Ebola virus transmission through breast milk is not concluded. 
3. Mother using an illicit street drug
Many lactating women take one or other medications which ultimately get transmitted to breast milk. But are usually in small quantities and unlikely to cause any side effects to the baby. Some illicit drugs like cannabis are known to cause motor impairment and developmental problems in infants.
Therefore, avoid exposure to these drugs at least for a period of six months during breastfeeding. Also, avoid exposure to passive smoking. 
Conditions In Which Mothers Should Temporarily Avoid Breastfeeding
4. Herpes simplex virus
If a mother has herpes lesions on the breast, she should avoid breastfeeding until the active lesions are treated. This is because the herpes simplex virus may get transmitted to infants during breastfeeding and increase their risk of mortality and morbidity. 
According to the CDC, mothers with no active lesions on breasts or lesions on other parts of the body, can breastfeed their child without any risk of transmission. 
Sepsis is a life-threatening condition caused by the body's extreme response to an infection. Sepsis may cause symptoms such as high fever, chills, lower abdominal pain, breathlessness, muscle pain and even death. This severe illness in mothers may cause temporary avoidance of breastfeeding. 
Breastfeeding is not recommended for a while for mothers who are on certain medications which may increase the toxicity of the breast milk and cause side effects to newborns.
They include sedating psychotherapeutic drugs, anti-epileptic drugs, radioactive iodine-131 (used for the treatment of thyroid cancer), excessive use of topical iodine or iodophors and cytotoxic chemotherapy drugs. 
7. Untreated brucellosis
Brucellosis is a bacterial infection that spreads from animals to humans, resulting in symptoms such as fever, body ache and weakness. In newborns, it is mainly transmitted through breast lumps and abscesses.
Therefore, until the infection is treated with antibiotics in lactating mothers, which may take around 4-6 weeks, breastfeeding is paused. 
Conditions In Which Mothers Should Temporarily Avoid Breastfeeding, But Can Feed Expressed Breast Milk
Breastfeeding in women living with tuberculosis (TB) is still contradicting. Some studies say that breast milk of women with TB can be given through optical feeding practices to their newborns, while other studies say that breast milk should be totally avoided as it may transfer the infection to babies.
A study has shown that women who are no longer infected with TB can safely breastfeed as it no longer contains the bacteria, and only a minor quantity of drugs which is non-toxic. 
9. Varicella infection
Varicella-zoster virus causes chickenpox, which is an acute infection transmitted mainly through person-to-person skin contact or through mucous membranes. A study talks about two cases of the varicella virus.
It says that upon evaluation, none of the cases has the virus isolated from their breast milk. This says that if mothers have varicella infection, they can still breastfeed their babies through expressed breast milk or other sources. 
10. Breast abscess
Breast abscesses are a common problem in lactating women caused due to multiple factors like infection or diabetes. It may cause pain while breastfeeding and progression of the abscess, if not paused for a while.
Therefore, experts say that if the abscess is present at other areas of the breast, apart from the nipples or feeding area, mothers may continue breastfeeding, while if it is present in the feeding area, breastfeeding should be temporarily stopped until the abscess is treated. 
11. Breast mastitis
Breast mastitis mainly occurs as a complication of breast abscess. It is an inflammatory condition of the breast, followed by signs of infections.
A study has shown that proper and timely treatment of breast mastitis can prevent cessation of breastfeeding, while if the condition is left untreated, breastfeeding must be paused for a while until the infection is treated. It is common in obese and diabetic women. 
Breastfeeding is a must for every newborn. However, due to certain maternal conditions, breastfeeding may be temporarily or permanently avoided for the safety of the child. If you have any of the aforementioned conditions, consult a medical expert soon and understand how to substitute breast milk for your child, without missing out on vital nutrients.
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