Which of the following is NOT considered a maternal contraindication to breastfeeding?

Bilateral silicone breast implants are not considered a maternal contraindication to breastfeeding. Women with breast implants can typically breastfeed successfully, as the implants do not usually affect the mother's ability to produce milk or the safe passage of milk to the infant. The placement of implants generally occurs behind the breast tissue or muscle, which allows for normal nipple and gland function.

In contrast, the other options represent significant health concerns that could pose risks to breastfeeding. Active tuberculosis is a communicable disease that can be transmitted to the infant through breast milk if untreated. HIV infection also poses a risk, as the virus can be present in breast milk, potentially leading to transmission to the infant. Substance abuse is a critical contraindication as it can affect the mother's health, impair her ability to care for her baby, and lead to exposure of harmful substances through breast milk. Hence, the presence of these serious health issues is a fundamental consideration in assessing the safety of breastfeeding for both mother and infant.