Vaccination is an important part of maternal and child health, and it's recommended that pregnant women get vaccinated against COVID-19.
But what about breastfeeding women and their babies?
Like pregnant women, breastfeeding women were excluded from COVID-19 vaccine trials, which means clinical safety data is still limited for this group.
However, real-world evidence — and a growing body of research — suggests COVID-19 vaccines are safe and effective for breastfeeding women and their children.
"[Researchers] have been monitoring what has been happening with pregnant and breastfeeding women, and there's been no concerns in terms of increased complications or side effects," said Karleen Gribble, adjunct associate professor at Western Sydney University's School of Nursing and Midwifery.
Dr Gribble added there were no theoretical safety concerns, based on what's known about similar vaccines, and that COVID-19 vaccines were not thought to pose any risk to lactating women or their infants.
In Australia, the Pfizer COVID-19 vaccine is recommended for breastfeeding women, and women are advised that they do not need to stop breastfeeding before or after vaccination.
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)Unlike pregnancy, breastfeeding does not appear to increase the risk of severe disease from COVID-19.
However, vaccination reduces the risk of breastfeeding women contracting COVID, getting sick, and spreading the virus to others.
"The recommendation for everybody is that as soon as you're eligible, get vaccinated. And the same goes for breastfeeding women," Dr Gribble said.
Vaccine effective in breastfeeding women
Preliminary research has found breastfeeding women generate the same antibody response to COVID-19 vaccines as people who are not lactating — meaning the vaccines are just as effective.
"Their response to the vaccine is not being impacted by the fact that they're breastfeeding," Dr Gribble said.
And in terms of side-effects, several small studies have shown that breastfeeding women have similar experiences after a mRNA COVID-19 vaccine — such as the Pfizer jab — as the general population.
Vaccine not passed on through breast milk
For many new parents, a key concern around COVID-19 vaccines is whether the vaccine could be harmful to their breastfeeding child.
The good news is that there is no evidence that the COVID vaccine can be passed on through breast milk.
"[Scientists] don't think that it's possible for the vaccine to get into the milk, but even if it did, it would be digested," Dr Gribble said.
The Pfizer jab — and other mRNA vaccines — do not contain any live virus. Instead, they deliver messenger RNA molecules which instruct the body to build replicas of the coronavirus spike protein.
The immune system learns to recognise this spike (and produce antibodies against it), and the highly fragile mRNA quickly breaks down.
Researchers at the University of California recently tested breast milk from seven women before and after they received an mRNA COVID-19 vaccine. They found no traces of mRNA in the mothers' breast milk.
While larger studies are needed to confirm the findings, the researchers said the results "strengthen current recommendations that vaccine-related mRNA is not transferred to the infant and that lactating individuals who receive the COVID-19 mRNA-based vaccine should not stop breastfeeding".
Antibodies may offer some protection to baby
As well as COVID vaccination offering protection to breastfeeding women, research suggests the vaccine may also have some benefits for their babies.
Several small studies have shown that breastfeeding women who have received a COVID-19 mRNA vaccine have antibodies in their breastmilk — which may provide their baby with some protection against the disease.
However, more research is needed (and is currently being done) to determine what protection these antibodies might provide.
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)Preliminary research conducted last year found antibodies in the breastmilk of women who had been infected with COVID-19 were able to neutralise the virus in the laboratory.
"They actually injected live SARS-CoV-2 into the milk, and the milk deactivated the virus," Dr Gribble said.
"There's not really any reason to believe that the antibodies in the milk of women who've been vaccinated wouldn't similarly work to deactivate SARS-CoV-2."
Dr Gribble said antibodies passed through breastmilk from other vaccines can be absorbed orally by the baby and offer some short-term protection — by way of fending off an infection before it takes hold.
"The way [breastfeeding women] provide that sort of protection is because they bathe the [child's] mouth and nasal cavity with milk — and that means if they happen to breathe in some respiratory virus … they've got antibodies hanging around that will help to deactivate it," she said.
"We don't know [if that's the case for COVID-19], but there is some evidence to suggest that it could be protective."
Breastfeeding women are encouraged to consult with their GP about receiving a COVID-19 vaccine.
The Department of Health also has a decision guide if you are considering COVID-19 vaccination and you are pregnant, breastfeeding, or planning pregnancy.
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2021-07-23 19:00:00Z
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