It can be difficult to keep up with all of the information and recommendations regarding the Covid-19 pandemic. We are learning more and more about the virus as time goes on and as we learn more, the recommendations are updated accordingly.
As a breastfeeding family, you might have specific questions about how coronavirus or the Covid-19 vaccine may affect your ability to breastfeed or your breast milk itself. There is a lot to talk about in regards to Covid-19, so today I am focusing specifically on Covid-19 and the Covid vaccine only as they relate to breastfeeding. I will review what we know so far, what the recommendations are for breastfeeding, and what we hope to learn in the future.
What do we know so far?
- The Covid-19 virus is not passed through breastmilk (your breastmilk alone won’t give your baby Covid). (Pace, 2021)
- If you test positive for Covid-19, you can continue to breastfeed! The CDC recommends wearing a mask when you are near your baby and washing your hands before touching your baby or your pump parts. (CDC.gov)
- None of the vaccines contain a live virus. Instead, they help your body to know how to build an immune response (build antibodies) against Covid-19, to help your body fight the virus if you get it in the future.
- Research shows that pregnant women and lactating women have the same ability to build immunity against Covid-19 after being vaccinated than those who receive the vaccine while not pregnant or breastfeeding (Gray, 2021).
The most exciting finding about Covid-19 and how it relates to breastfeeding is that Covid antibodies have been found in breastmilk! People who have had Covid-19 infection and people who have had the Covid vaccine have the antibodies in their milk (Young, 2021). Based on what we know about breastmilk and how antibodies in breastmilk help the body fight other infections, this is very exciting news!
A recent study published in JAMA Pediatrics (Young, 2021) compared the breastmilk of people who had a previous Covid infection with the breastmilk of people who had received the Covid vaccine (either Pfizer or Moderna). The neat thing is that breast milk from both groups had Covid antibodies and demonstrated the ability to “neutralize” or block the virus. Even more interesting is that the type and amount of antibodies were different in the two groups, though we don’t yet know what affect this has on the antibodies’ ability to offer protection via the breastmilk. The milk from the group who had Covid was IgA (the antibody mostly found in the respiratory and digestive tracts) dominant and the vaccinated group’s milk showed a strong IgG (the antibody mostly found in the blood) response.
While it is amazing that Covid-19 antibodies have been found in breastmilk and while we believe they offer some sort of protection for the baby, we do not know at this time how MUCH protection these antibodies offer the baby or how long that protection might last. Your baby is not fully protected against Covid-19 just because they’ve received your breastmilk after you’ve had Covid or had the Covid-19 vaccine.
What are the vaccine recommendations for breastfeeding moms?
- The Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine (SMFM) all have statements regarding the vaccine. These statements are best summed up by this ACOG key recommendation, “That all eligible persons greater than age 12 years, including pregnant and lactating individuals, receive a COVID-19 vaccine or vaccine series.” (ACOG.org)
- It is important to remember that it is not necessary to wean from breastfeeding if you get the vaccine.
- The recommendations for pregnant and breastfeeding women to receive the vaccine are based on its ability to protect YOU from severe illness. Any protection that your baby gets if you receive the vaccine while breastfeeding is just a great bonus!
Frequently Asked Questions
“I am breastfeeding my baby but I have older children. Can I give my other kids my breastmilk and will it help protect them against Covid?”
You can definitely give your other children your breastmilk! However, just like with babies, we still don’t know what level of protection against Covid-19 the antibodies in the breastmilk offer, or if there is a certain amount of milk needed in order to see some protection. But it can’t hurt!
“Will the vaccine itself travel into my breastmilk and cause my baby to have side effects?”
“The Academy of Breastfeeding Medicine states that there is little plausible risk that vaccine nanoparticles or mRNA would enter breast tissue or be transferred to milk” (Golan, 2021). In a study of 13 human milk samples collected between 4 and 48 hours post-vaccination, none of the samples showed detectable levels of vaccine mRNA (Golan 2021). This was a small study, but reassuring nonetheless.
“If a mother confirmed/suspected to have COVID-19 does not have a medical face mask should she still breastfeed?”
“The World Health Organization states Yes. Breastfeeding unquestionably reduces neonatal and infant mortality and provides numerous lifelong health and brain development advantages to the infant/ child. Mothers with symptoms of COVID-19 are advised to wear a medical mask, but even if this is not possible, breastfeeding should be continued. Other infection prevention measures, such as washing hands, cleaning surfaces, sneezing or coughing into a tissue are also important. Non-medical masks (e.g. home-made or cloth masks) have not been evaluated. At this time, it is not possible to make a recommendation for or against their use (WHO).”
Areas for future research
We know there are many more studies and clinical trials related to pregnancy and breastfeeding and Covid going on right now! Researchers are working hard to continually bring us the most up to date information. In the future, I hope that we are able to learn more about how the antibodies found in breastmilk might help to protect the baby.
We will share more information as it’s released! Please be sure to gather your information on this topic from trusted sources (like ACOG and SMFM), and always check in with your doctor regarding questions you may have.
Jessica McKee, RN, IBCLC + Lactation Link team
Gray, K. J., Bordt, E. A., Atyeo, C., Deriso, E., Akinwunmi, B., Young, N., Baez, A. M., Shook, L. L., Cvrk, D., James, K., De Guzman, R., Brigida, S., Diouf, K., Goldfarb, I., Bebell, L. M., Yonker, L. M., Fasano, A., Rabi, S. A., Elovitz, M. A., Alter, G., … Edlow, A. G. (2021). Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study. American journal of obstetrics and gynecology, 225(3), 303.e1–303.e17.
Golan Y, Prahl M, Cassidy A, et al. Evaluation of Messenger RNA From COVID-19 BTN162b2 and mRNA-1273 Vaccines in Human Milk. JAMA Pediatr. 2021;175(10):1069–1071. doi:10.1001/jamapediatrics.2021.1929
Pace RM, Williams JE, Järvinen KM, Belfort MB, Pace CDW, Lackey KA, Gogel AC, Nguyen-Contant P, Kanagaiah P, Fitzgerald T, Ferri R, Young B, Rosen-Carole C, Diaz N, Meehan CL, Caffé B, Sangster MY, Topham D, McGuire MA, Seppo A, McGuire MK. Characterization of SARS-CoV-2 RNA, Antibodies, and Neutralizing Capacity in Milk Produced by Women with COVID-19. mBio. 2021 Feb 9;12(1):e03192-20. doi: 10.1128/mBio.03192-20. PMID: 33563823; PMCID: PMC7885115.
Young BE, Seppo AE, Diaz N, et al. Association of Human Milk Antibody Induction, Persistence, and Neutralizing Capacity With SARS-CoV-2 Infection vs mRNA Vaccination. JAMA Pediatr. Published online November 10, 2021. doi:10.1001/jamapediatrics.2021.4897