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Coronavirus and Breastfeeding: What do I need to Know?

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Most of the lactating physician moms I know are receiving the COVID-19 vaccine and continuing to breastfeed.  Many hope they might even be passing some immunity on to their babies through their breast milk after being vaccinated, but there is debate on this. It is felt that most of the antibodies that might be secreted in the milk are likely digested by the infant rather than making it into their body as intact, active antibodies.  There is a possibility that some secretory IgA antibodies (which play an important role in immune protection of mucus membranes, including the gut) from the vaccinated mother’s milk could be functional for the infant.

The Practice Advisory on Vaccinating Pregnant and Lactating Patients Against COVID-19 issued by the American College of Obstetricians and Gynecologists (ACOG) states, “ACOG recommends COVID-19 vaccines be offered to lactating individuals similar to non-lactating individuals when they meet criteria for receipt of the vaccine based on prioritization groups outlined by the ACIP. 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 (ABM 2020).”  They point out that several vaccines have safely been given to pregnant and lactating individuals for decades.

The CDC states mRNA vaccines are not thought to be a risk to the breastfeeding infant and that a lactating person who is part of a group recommended to receive a COVID-19 vaccine may choose to be vaccinated.  They do state that there are no data on the safety of COVID-19 vaccines in lactating people or the effects of mRNA COVID-19 vaccines on the breastfed infant or on milk production/excretion.

Several ongoing studies, including out of Mount Sinai and San Diego, are looking into the safety of COVID-19 vaccination and breastfeeding and we hope to have more data soon.

Jennifer Abrams, MD, February 15, 2021