Keeping breastfeeding safe

Breast milk is the best food for babies during the first year of life. Breastfeeding is good for both you and your baby. But some medical conditions can make breastfeeding harmful for a baby. Talk to your provider if you think you have a condition that makes you unsure about breastfeeding.

What medical conditions make breastfeeding unsafe for your baby?

Don’t breastfeed your baby if:

  • Your baby has galactosemia. Babies with this problem can’t break down the sugar in any kind of milk, including breast milk and cow’s milk. They can have brain damage or even die if they eat or drink milk products. Babies with galactosemia must be fed a special formula that is not made with milk of any kind.
  • You have HIV (human immunodeficiency virus), the virus that causes AIDS. If you have HIV, you can pass it to your baby through breast milk.
  • You have untreated, active tuberculosis. This is an infection that mainly affects the lungs.
  • You have human T-cell lymphotropic virus. This is a virus that can cause blood cancer and nerve problems.
  • You’re taking cancer drugs. Some medicines used to treat cancer can pass through breast milk and harm a baby.
  • You’re getting radiation treatment.

Can medicines and herbal products you take while breastfeeding hurt your baby?

Most prescription and over-the-counter medicines you take don’t harm your baby. A prescription is an order for medicine written by a health care provider. Over-the-counter medicines are medicines, like pain relievers or cough syrup, you can buy without a prescription. To be safe, ask your provider before you take any kind of medicine while you’re breastfeeding.

Some medicines, like those that treat cancer and migraine headaches, may hurt your baby if you’re breastfeeding. Some medicines may lessen your milk supply. Tell your provider about any medicines you take. If they aren’t safe for breastfeeding, you may need to switch to safer ones. Tell your provider about all the medicines you take before you start breastfeeding.

Don’t take any herbal products while you’re breastfeeding. These include ginkgo and St. John’s wort. Even though herbs are natural, they may not be safe for your baby.

Can you pass street drugs to your baby through breast milk?

Yes. You can pass street drugs, like marijuana, cocaine and heroin, to your baby through breast milk. Don’t use street drugs if you’re breastfeeding.

Can you pass alcohol to your baby through breast milk?

Yes. Don’t drink alcohol when you’re breastfeeding. Alcohol includes beer, wine, wine coolers and liquor. If you choose to drink alcohol, don’t have more than two drinks a week. Wait at least 2 hours after each drink before you breastfeed.

Can smoking while breastfeeding hurt your baby?

Yes. Nicotine is a drug found in cigarettes. It passes to your baby in breast milk and can cause problems, like:

  • Making your baby fussy
  • Making it hard for your baby to sleep
  • Reducing your milk supply so your baby may not get all the milk he needs

Secondhand smoke also is bad for your baby. Secondhand smoke is smoke from someone else’s cigarette, cigar or pipe. It can cause lung and breathing problems. Babies of mothers who smoke are more likely than babies of non-smokers to die from sudden infant death syndrome (SIDS). SIDS is the unexplained death of a baby while sleeping.

Don’t smoke if your breastfeeding. If you do smoke, it’s OK to breastfeed. But smoke as little as possible and don’t smoke around your baby.

Can you have caffeine when you’re breastfeeding?

Limit caffeine while you’re breastfeeding. Caffeine is a drug that is found in things like coffee, tea, soda, chocolate and some medicines. Too much caffeine in breast milk can make your baby fussy or have trouble sleeping. If you drink coffee, have no more than two cups a day while you’re breastfeeding.

Can you breastfeed if you’re sick?

Yes, but tell your health care provider right away that you’re not feeling well. It’s safe to breastfeed if you have a common illness, like a cold or the flu. Breastfeeding passes along antibodies (cells in the body that fight off infection) to your baby that can help protect him from the illness. Don’t take any medicine without talking to your provider first.

Can you breastfeed if you’ve had breast surgery or piercing on the breast?

Yes. Breast surgery includes getting implants, having a breast reduction or having a lump removed. Piercing means inserting jewelry into the breast, including nipple piercing. If you’ve had breast surgery or piercing, you may need extra help with breastfeeding from your provider or a lactation consultant. A lactation consultant is a person with special training in helping women breastfeed.

Is it safe to breastfeed your baby in bed?

Yes. You can breastfeed anywhere you can get comfortable with your baby. But don’t fall asleep if you breastfeed in bed. This could cause your baby to suffocate (stop breathing). And put your baby to bed in his own crib or bassinet.

Last reviewed February 2012

See also: Breastfeeding your baby in the NICU, Breastfeeding: What dad can do, How to breastfeed, Using a breast pump, A visit with a breastfeeding support group

Most common questions

How much vitamin D should my baby get?

Vitamin D is important to help avoid a bone-weakening disease called rickets. All babies should receive 400 IU of vitamin D per day, starting in the first few days of life. This includes breastfed babies and babies who drink less than 1L of infant formula per day.

Our skin makes vitamin D when it gets sunlight. But too much sunlight can be harmful, too. In fact, babies 6 months and older and young kids should stay away from direct sunlight and wear sunscreen at all times when out in the sun. However, sunscreen stops the skin from making vitamin D. The best way to get enough vitamin D is by giving your baby liquid multivitamin drops with vitamin D. They can be found in many pharmacies, and you won't need a prescription for it. Just be sure you've filled the dropper to no more than 400 international units (IU).

How often should I nurse my baby?

All babies are different and have different feeding patterns. In general, breastfed newborns need to eat 8 to 12 times in 24 hours (about once every 2 to 3 hours), for about 30 minutes each time. Breast milk is easily digested so it may be difficult to time when you should nurse your baby.

Newborns may need to feed more frequently than older babies. They may need to be fed on demand. As your milk supply is established and the baby grows, the baby's feeding patterns may change and she may go longer between feedings. Remember, breastfeeding is a natural skill, but it’s also a learned skilled. Be patient and give yourself (and your baby) time to master this new ability.

What solids foods should I start my baby on?

Begin with a single-grain iron-fortified cereal such as rice, barley or oatmeal. Mix it with breast milk or infant formula. Start with a small amount once a day. It's hard to tell how much your baby will eat. At first, most of her food will probably end on her bib or face. Be patient and help your baby learn this new skill. It's important that meal time is a pleasant time. This will build the foundation of healthy eating habits. If your baby cries, shows no interest in feeding or turns her head away from the spoon, stop feeding her. She is trying to tell you that she's full or she doesn’t want anymore. You should never force her to eat more than what she wants.

When should I give my baby solid foods?

Breast milk is the best food for most babies. It's best to give only breast milk for the first 6 months of life. Some babies might be ready to start solid foods between 4 to 6 months of age. When your baby is between 4 to 6 months, she may begin to show signs that she's ready to try some solid foods alongside her breast milk or formula. Watch for her developmental cues (signs) and she'll let you know when she's ready. Some signs that show your baby might be ready to start solid foods are:

  • She can sit with support.
  • She shows a good head neck control when seated.
  • She shows a desire for food by opening her mouth, drooling and leaning forward.
  • She begins to chew and brings her hands to her mouth.
  • She begins to handle objects with the palm of her hand.
  • She swallows pureed food and the extrusion reflex starts to go away (tongue-thrust reflex).
©2013 March of Dimes Foundation. The March of Dimes is a non-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3).