Covid Vaccine and Breastfeeding

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We know that there is overwhelming research showing that breastfeeding protects infants’ respiratory systems (in general). Some of you have asked about resources regarding the Covid Vaccine and Breastfeeding. 

According to the Academy of Breastfeeding Medicine (ABM) during lactation, it is unlikely that the vaccine lipid would enter the bloodstream and reach breast tissue. While there is little plausible risk for the child, there is a biologically plausible benefit. Antibodies and T-cells stimulated by the vaccine may passively transfer into milk. Following vaccination against other viruses, IgA antibodies are detectable in milk within 5 to 7 days. Antibodies transferred into milk may therefore protect the infant from infection with SARS-CoV-2. Although the biology is reassuring, for definitive information, we will have to wait for data on outcomes once the vaccine is used in lactating individuals and their children 1.

American College of Obstetricians and Gynecologists (ACOG) recommends COVID-19 vaccines be offered to lactating individuals. While lactating individuals were not included in most clinical trials, COVID-19 vaccines should not be withheld from lactating individuals who otherwise meet criteria for vaccination. Theoretical concerns regarding the safety of vaccinating lactating individuals do not outweigh the potential benefits of receiving the vaccine. There is no need to avoid initiation or discontinue breastfeeding in patients who receive a COVID-19 vaccine 2. 

According to the Centers for Disease Control and Prevention (CDC), clinical trials for the COVID-19 vaccines currently authorized for use under an Emergency Use Authorization in the United States did not include people who are breastfeeding. Because the vaccines have not been studied on lactating people, there are no data available on:

  • The safety of COVID-19 vaccines in lactating people
  • The effects of vaccination on the breastfed infant
  • The effects on milk production or excretion

The COVID-19 vaccines authorized now are non-replicating vaccines, meaning they are able to create an immune response but do not reproduce inside host cells. Because non-replicating vaccines pose no risk for lactating people or their infants, COVID-19 vaccines are also thought to not be a risk to the breastfeeding infant. Therefore, lactating people may choose to be vaccinated 3. 

In a cohort of 6 lactating women who received 2 doses of SARS-CoV-2 vaccine at the Providence Portland Medical Center in Oregon, researchers observed significantly elevated levels of SARS-CoV-2 specific IgG and IgA antibodies in breast milk beginning at day 7 after the initial vaccine dose, with an IgG-dominant response. This article is a preprint and has not been peer-reviewed, so it should not be used to guide clinical practice 4.

Breastfeed Durham put together a list of all the research and articles that we find most informative.

  1. ABM on Covid: https://abm.memberclicks.net/abm-statement-considerations-for-covid-19-vaccination-in-lactation
  2. ACOG on Covid, Vaccines, and pregnancy/breastfeeding https://www.acog.org/en/Womens%20Health/FAQs/Coronavirus%20COVID-19%20Pregnancy%20and%20Breastfeeding?fbclid=IwAR2sKbp7a1yErZ8-svaTKZwvq0JueIHhhaGE-j0oGgd0fyH92GSWpkhkhos
  3. CDC:Information about COVID-19 Vaccines for People who Are Pregnant or Breastfeeding
  4. Jill K. Baird, Shawn M. Jensen, Walter J. Urba, Bernard A. Fox, Jason R. Baird. SARS-CoV-2 antibodies detected in human breast milk post-vaccination. doi: https://doi.org/10.1101/2021.02.23.21252328
  5. Gray KJ, Bordt EA, Atyeo C, Deriso E, Akinwunmi B, Young N, Medina Baez A, Shook LL, Cvrk D, James K, De Guzman R, Brigida S, Diouf K, Goldfarb I, Bebell LM, Yonker LM, Fasano A, Rabi SA, Elovitz MA, Alter G, Edlow AG, COVID-19 vaccine response in pregnant and lactating women: a cohort study, American Journal of Obstetrics and Gynecology (2021), doi: https:// doi.org/10.1016/j.ajog.2021.03.023 (Journal Pre-proof/22 March 2021)
  6. Antibodies For Covid-19 Found In Breast Milk After Vaccine: https://www.forbes.com/sites/ninashapiro/2021/03/04/antibodies-for-covid-19-found-in-breast-milk-after-vaccine/?sh=3cea44fc6f4e
  7. Free infographic-Breastfeeding and COVID-19: https://stores.praeclaruspress.com/free-infographic-breastfeeding-and-covid-19/?fbclid=IwAR2W5PCR1M5QEowNVlh30cuJnVOnRgq2pjyMzt1R3mgVzei-ePpX8mEfzzA
  8. This was a free discussion that was recently done. https://register.gotowebinar.com/register/373656245794158349?fbclid=IwAR2iGfiOtgDvxvEC99ySPmBVKbRz3q9AyysqUTQRm9GnCYbVkQ24zqDXAlU
  9. Some information on current studies happening https://www.urmc.rochester.edu/research/health-research/covid-19-research-studies.aspx
  10. Maternal and Infant Outcomes Associated with Maternity Practices Related to COVID-19: “The COVID Mothers Study Maternity care practices such as skin-to-skin care, rooming-in, and direct breastfeeding are recommended, but it [was] unclear if these practices increase the risk of clinically significant COVID-19 in newborns, and if disruption of these practices adversely affects breastfeeding…Disruption of evidence-based quality standards of maternity care is associated with harm and may be unnecessary.” https://www.liebertpub.com/doi/pdf/10.1089/bfm.2020.0353 
  11. LACTFACT “Antibodies in Human Milk After COVID-19 Vaccine Antibodies to SARS-CoV-2 virus are present in human milk after the mRNA COVID-19 vaccine is given during lactation. The degree to which these IgG antibodies protect infants is unclear” by Anne Eglash MD, IBCLC, FABM https://lacted.org/questions/0220-covid-antibodies-human-milk/?utm_source=mailpoet&utm_medium=email&utm_campaign=CQW%23220