Which condition should NOT lead to breastfeeding cessation in developing countries?

In many developing countries, the recommendation regarding breastfeeding for mothers with HIV infection is nuanced due to the risk of vertical transmission of the virus to the infant. However, current guidelines often promote breastfeeding as a safe practice under certain circumstances, particularly when mothers are on effective antiretroviral therapy (ART) and have an undetectable viral load. This approach supports the notion that the benefits of breastfeeding—such as providing essential nutrients, immune protection, and reducing the risk of other infections—often outweigh the risks associated with HIV transmission when appropriate treatment is in place.

In contrast, situations involving active untreated tuberculosis, herpes lesions on the breast, and drug abuse typically present more acute health risks either to the child or the mother, warranting a cessation of breastfeeding. For instance, active untreated TB can be aerosolized, and the risk of infection increases significantly for the infant. Herpes lesions pose a direct risk of transmission through contact. Drug abuse may affect the mother's capability to care for the child adequately and also poses risks through contaminating breast milk.

Thus, with appropriate medical management, including ART for mothers with HIV, breastfeeding can be continued, making it a viable option in developing countries where the overall health benefits can significantly contribute to a child's wellbeing.