Two contraindications to breastfeeding in the postpartum period.

• A. Maternal HIV infection and active untreated tuberculosis or use of illicit drugs
• B. Maternal HIV infection and diabetes mellitus
• C. Active untreated tuberculosis or illicit drug use and preeclampsia
• D. Illicit drug use and obesity

Answer: (A)

Breastfeeding is avoided when the mother has conditions that could put the infant at risk through transmission or exposure. The two contraindications shown here are maternal HIV infection, and either active untreated tuberculosis or illicit drug use. HIV can be transmitted to the infant through breast milk, so breastfeeding is not recommended in mothers with HIV. Active untreated tuberculosis means the mother is contagious, which poses a risk to the infant, so breastfeeding should be withheld until treatment makes the mother noncontagious. Illicit drug use is another contraindication because many drugs pass into breast milk and can harm the infant.