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Nutramigen) breastfeeding is contra-indicated when mothers are receiving diagnostic or therapeutic radioisotopes, or have had exposure to radioactive materials (for as long as there is radioactivity in the milk) breastfeeding is contra-indicated for mothers who are receiving certain medications, anti-metabolites or chemotherapeutic agents (Table 1) duration of interruption of breastfeeding depends on the drug lactation should be maintained with expression breastfeeding may be re-established as early as 1-2 maternal drug half-lives following the last dose of most toxic drugs breastfeeding may be contraindicated for mothers taking certain street drugs (Table 2) breast feeding is contra-indicated for mothers with certain infectious diseases (see below) Maternal Infections and Breastfeeding Human Immunodeficiency Virus (HIV) In the developed world, HIV positive mothers should not breastfeed In developing countries without access to replacement feeding that is acceptable, feasible, affordable, sustainable, and safe (WHO AFASS recommendations), the increased risk of other infectious diseases and nutritional deficiencies with increased infant death rates associated with artificial feeding, outweighs the possible risks of acquiring HIV infection from breastfeeding and improves HIV-free survival, likely with or without maternal anti-retroviral therapy (ART)

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