| Medical Issues | Safety |
| Hepatitis B | Safe, no risk |
| Hepatitis C | Safe, HCV RNA detected in breast milk |
| HIV | Absolute CONTRAINDICATION |
| Substance Issues | Safety |
| Active Heavy Alcohol or Drug Use (Cocaine, Marijuana) |
> Relative CONTRAINDICATION to breastfeeding due to infant toxicity > Abstinence recommended while breastfeeding |
| Occasional Moderate Alcohol or Drug Use |
> All agents are detected in breast milk > Abstinence recommended while breastfeeding > Alcohol may decrease let-down reflex and suppress lactation; delay nursing for 1-2 hours per drink to minimize infant exposure > Stimulants: advise women not to breastfeed within 3 days of using (pump and dump) > Marijuana: may cause lethargy and poor feeding in infants |
| Methadone | Safe no risk |
| Buprenorphine | Safe, limited data available |
