There are few contraindications to breastfeeding/chestfeeding because of the infant's medical condition.

Absolute contraindications:

  • Classical galactosaemia

  • Congenital lactose intolerance

Relative contraindications:

  • High flow therapy - may be possible for stable patients. May require SALT review first, for example in the setting of prematurity

  • Other metabolic disorders - The American Academy of Pediatrics advises that "alternating breastfeeding with special protein-free or modified formulas can be used in feeding infants with other metabolic diseases (such as phenylketonuria), provided that appropriate blood monitoring is available". One case series reports predominantly success with a variety of metabolic disorders, another showed variable success. Partial breastfeeding in phenyloketonuria is well established, and breastfeeding may be linked to lower phenylalanine levels and higher weight gain for the infant.

Problems with oral intake:

If lack of oral feeding is the only problem, babies can be fed expressed milk. Parents will need expert advice on establishing or maintaining milk supply with exclusive expressing, which follows the same principles as for very preterm babies outlined here.

If supplementary feeds are necessary but oral feeding is not contraindicated, remember breastfeeding/chestfeeding is a source of comfort for parent and child, and is particularly useful for analgesia during painful procedures. Babies who are mixed fed can receive infant formula while suckling at the breast/chest with a supplementary nursing system (also called an at breast supplementer).

Breastfeeding/chestfeeding is not all or nothing

There are many ways to retain some of the valuable breastfeeding/chestfeeding experience even if oral feeds are not possible or need to be supplemented with other feeding modes or types of milk


Thank you for visiting the Hospital Infant Feeding Network. This website is a repository of relevant knowledge and best practice resources for health professionals. To join the conversation, ask questions and share your experiences please join us on Facebook or Twitter.


We will be running Q&A sessions on various topics, which will be advertised on our social media sites. Please email if you have ideas or want to get more involved. We welcome health professionals passionate about supporting breastfeeding/chestfeeding and lactation in the hospital setting to join our steering group, please get in contact if this is you!

You may have noticed that we use 'additive' language on our website to refer to lactation and human milk feeding. This means that we might refer to 'breastfeeding/chestfeeding'. Chestfeeding is a term that some non-binary people use to refer to feeding their child at the chest if the word breast is not congruent with their gender identity. Using additive language helps reduce a feeling of exclusion for non-binary and transgender people, without taking away from the importance of words like breastfeeding and mother. We do not always use additive language - for example when using infographics created by other organisations or referring to scientific research that didn't use additive language as this may not generalisable. There is a much more detailed description of the additive approach here.

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