Is the Covid Vaccine Safe for Breastfeeding Mothers?

Diving Deeper Into The Covid-19

Vaccine and Breastfeeding

 Information You Want

As a new mom, you want more than anything to keep your baby healthy and safe. Introducing them to the world can feel frightening, especially with a global pandemic that appears unrelenting at times. 

Moms will frequently ask me since I’m an IBCLC, what they can do to better protect their newborns. The good news is, if you’re asking a lactation consultant, chances are you’re already doing so much to protect your little one. 

Newborn babies cannot create antibodies to protect themselves effectively for anywhere from three to six months. Because our bodies are honed to protect our little ones, mother’s breast milk is concentrated with antibodies to fight various threats. 

A specialist of medication use and safety in pregnancy and lactation, Hedvig Nordeng, goes as far as to say “Breast milk by itself is more than nutrition, breast milk is medicine… It’s specifically designed by the mother, and by Mother Nature to provide the child with the child’s first vaccine (Hall, 2021).” 

Today, we’re diving into the information you want on vaccines and breastfeeding your baby. We’re going to get real deep on the COVID-19 vaccine and breastfeeding since this is such a huge topic now.

How Does Breastmilk Provide Protection?

This “vaccine” provided through breastmilk isn’t like one we line up at the pharmacy to receive, breastmilk functions much differently. The antibodies found in breastmilk, coat the mouth, throat, and gut of the baby until they’re digested, never making it into the infant’s bloodstream. 

When bacteria or viruses come in contact with the fortified mouth or throat of a breastfed baby, studies show that the antibodies present are neutralized. However, protection is never a “one and done” convenience; the antibodies need to be replenished throughout the day to continue to provide their benefits (Hall, 2021). 

But how does all of this relate?

For the first time, we’re finally getting answers about how COVID-19 applies to new moms, specifically breastfeeding ones. Unfortunately, many of the early studies excluded them. 

Early instructions suggested that COVID-positive mothers needed to cease breastfeeding during their illness out of risk that their child could get the virus from the milk. Later, concerns for the vaccine left mothers hesitant about how it would affect the contents of their milk. 

However, current studies speak highly of the benefits of the COVID-19 vaccine as a source of protection for new moms as well as their babies. 

There is a difference between induced immunity and natural immunity. In a study done comparing natural immunity to vaccine-induced immunity, it was found that the immune transfer to neonates through the placenta and breastmilk was increased through the vaccine. 

While the original vaccine studies excluded pregnant and breastfeeding women, the current studies suggest that the Coronavirus 2019 RNA vaccines generate a robust immunity in pregnant and lactating women, comparable to the rest of the population (Grey et al, 2021). 

The Very Rare But Serious Side Effects

There are additional things to take into consideration when deciding to get vaccinated or not. The Center for Disease Control and Prevention (CDC) reports that while rare, there are four serious adverse events following COVID-19 vaccination. Those include: 

• Anaphylaxis: a severe allergic reaction that can present as hives, difficulty breathing, low blood pressure, swelling in the lips or tongue. This side effect is rare, occurring in only five out of one million people (CDC, 2021).

• Thrombosis with Thrombocytopenia syndrome (TTS): this is a condition of clots forming in the veins, coupled with low platelet levels, causing difficulty in forming blood clots. Only 54 people in total have been found to have this condition specifically after the Johnson and Johnson vaccine, however women ages 50 and under are at increased risk and should consider other vaccine options (CDC,2021).

• Myocarditis and pericarditis: the term “-itis” breaks down to mean inflammation, so “myocarditis” means inflammation of the heart muscle and “pericarditis” breaks down to inflammation around the heart. Both of these side effects are extremely rare and tend to resolve without incidence. But are seen more commonly with the Pfizer and Moderna vaccines. It’s important to note the potential of these side effects in 0.00213% of those vaccinated, while those who contract COVID-19 are approximately 70 times more likely to suffer from myocarditis or pericarditis due to contracting COVID-19 (Boehmer, 2021).

• Guillain-Barre Syndrome (GBS): a rare autoimmune disorder where a person’s immune system attacks the nervous system causing mild muscle weakness to sometimes complete paralysis. GBS is a potential side effect with any vaccine and has been reported mostly in men, ages 50 years and older (CDC,2021)

The CDC goes on to emphasize that the benefits of vaccination outweigh the risk. If you have any concerns about getting vaccinated or are questioning whether or not it’s right for you, I encourage you to talk it over with your primary care provider. 

To say there are no side effects beyond body aches for a day is untrue, thankfully, the severe side effects are rare and the risk of severe COVID-19 infection remains greater than the possibility of a severe reaction.

Another concern voiced is whether or not the vaccine will pass through breastmilk. In a study examining mother’s milk post vaccination for 48 hours, it was found that “none of the samples showed detectable levels of vaccine mRNA in any component of the milk,” (Golan, 2021). Mothers do not need to pause in breastfeeding to get the vaccine if they want it.

You Can Still Breastfeed If You End Up COVID Positive 

Any form of immunity is beneficial to both baby and mom. One of the early suggestions for COVID-positive mothers was to dump their breastmilk. However, one study examined breastmilk of mothers, testing COVID 19 positive, it was found that none of the viruses was passed through the breastmilk. Breast skin could have the virus on the surface when breastfeeding, still more studies need to be done to gauge this concern. 

Regardless, the milk of the mother was found to contain antibodies that neutralize the virus, coating the baby’s mouth with protection. The results of this study support the continuation of breastfeeding in mothers with mild to moderate cases of COVID 19, as the milk will continue to provide benefits to the baby to support a healthy immune system (Pace, 2021).

Another study looked at mothers' breastmilk who recently recovered from COVID-19, they found it had a rich supply of COVID antibodies present (Van Keulen, 2020). If you’ve had COVID-19 recently, know that you can provide protection through your natural immunity to your baby through breastfeeding as well.

Whether you’ve had COVID 19 recently, been immunized, or currently find yourself sick with COVID 19, there is one thing you can do to best help your baby’s immune system: Breastfeed. 

If this suggestion feels too difficult or out of reach, please contact me. Know that I am here to help in your breastfeeding journey and support your goals.

Learn How I Can Help Your Breastfeeding Journey Here!

References:

Boehmer, T. K., Kompaniyets, L., Lavery, A. M., Hsu, J., Ko, J. Y., Yusuf, H., Romano, S. D., Gundlapalli, A. V., Oster, M. E., & Harris, A. M. (2021). Association between COVID-19 and myocarditis using hospital-based administrative data — United States, March 2020–January 2021. MMWR. Morbidity and Mortality Weekly Report, 70(35), 1228–1232. https://doi.org/10.15585/mmwr.mm7035e5

 Centers for Disease Control and Prevention. (2021, December 16). Safety of covid-19 vaccines. Centers for Disease Control and Prevention. Retrieved December 19, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/safety-of-vaccines.html

 Golan, Y., Prahl, M., Cassidy, A., Lin, C. Y., Ahituv, N., Flaherman, V. J., & Gaw, S. L. (2021). Evaluation of messenger RNA from COVID-19 BTN162b2 and mRNA-1273 vaccines in human milk. JAMA Pediatrics, 175(10), 1069. https://doi.org/10.1001/jamapediatrics.2021.1929

 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., … 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). https://doi.org/10.1016/j.ajog.2021.03.023

 Hall, S. (2021). Covid vaccines and breastfeeding: What the data say. Nature, 594(7864), 492–494. https://doi.org/10.1038/d41586-021-01680-x

 Pace, R. M., Williams, J. E., Järvinen, K. M., Belfort, M. B., Pace, C. D., Lackey, K. A., Gogel, A. C., Nguyen-Contant, P., Kanagaiah, P., Fitzgerald, T., Ferri, R., Young, B., Rosen-Carole, C., Diaz, N., Meehan, C. L., Caffé, B., Sangster, M. Y., Topham, D., McGuire, M. A., … McGuire, M. K. (2021). Characterization of SARS-COV-2 RNA, antibodies, and neutralizing capacity in milk produced by women with covid-19. MBio, 12(1). https://doi.org/10.1128/mbio.03192-20

 Van Keulen, B. J., Romijn, M., Bondt, A., Dingess, K. A., Kontopodi, E., van der Straten, K., den Boer, M. A., Bosch, B. J., Brouwer, P. J. M., de Groot, C. J. M., Hoek, M., Li, W., Pajkrt, D., Sanders, R. W., Schoonderwoerd, A., Tamara, S., Timmermans, R. A. H., Vidarsson, G., Stittelaar, K. J., … van Goudoever, J. B. (2020). Breastmilk; a source of SARS-COV-2 specific IGA antibodies. https://doi.org/10.1101/2020.08.18.20176743