In which situation would the primary health care provider advise a new mother against breastfeeding?

A primary health care provider would advise against breastfeeding in the context of HIV infection because the virus can be transmitted from the mother to the infant through breast milk. The risk of transmission is significant, and even with effective antiretroviral therapy, breastfeeding poses a potential health hazard for the infant. The standard recommendation is to use formula feeding as a safer alternative to eliminate the risk of HIV transmission.

In situations like mastitis, inverted nipples, or herpes genitalis, breastfeeding may still be possible, often with appropriate management or support. Mastitis can be treated with antibiotics, and the act of continuing to breastfeed can actually help resolve the condition. Inverted nipples may pose some challenges, but many mothers successfully breastfeed with proper techniques or devices to assist. Herpes genitalis might present a concern if lesions are present on the breast, but breastfeeding is not categorically contraindicated in the absence of active lesions.

Therefore, the unique nature of the HIV risk explicitly dictates the recommendation against breastfeeding in this scenario.