Prioritization of lactation services during the pandemic has been problematic globally. Families have had difficulty accessing evidence-based lactation support and care. In many hospitals in the United States and globally, the World Health Organization (2019) recommendations for early, exclusive breastfeeding and skin-to-skin contact were not followed. And now we come to another critical crossroad in protecting breastfeeding families with the release of the COVID-19 vaccines globally. The congressional Taskforce on Research Specific to Pregnant Women and Lactating Women (2018) specifically called for pregnant and lactating women to be including in research on new drugs and therapeutics. However, neither pregnant nor lactating women were included in the trials developing the COVID-19 vaccines. Thus, since the vaccines have been released worldwide, many parents are seeking information about the safety of getting the vaccine and continuing to breastfeed. My recommendation is yes to both.
The vaccines from Pfizer and Maderna are mRNA vaccines. These vaccines give the muscle cell instructions to make a spike protein. The spike protein is on the surface of the virus that allows the virus to attach to the body's cells. Once the mRNA instructions are inside muscle cells, a lot of spike protein is produced and is moved to the surface of the cell (Infant Risk Center, 2020). The immune system quickly recognizes that the spike protein does not belong there and starts making antibodies thus creating the immunity to the COVID-19 virus (Infant Risk Center).
The benefit of all vaccines is protection from future infections. With the COVID-19 vaccines, recipients are never exposed to a live virus in the vaccine. The American College of Obstetricians and Gynecologists (2020) recommends that COVID-19 vaccines should be offered to lactating parents similar to nonlactating persons who meet criteria for receipt of the vaccine based on prioritization groups outlines by the Advisory Committee on Immunization Practices (2021). The Society for Maternal-Fetal Medicine (2020) advises that all pregnant women have access to and be offered the COVID-19 vaccine, including health care workers. According to the Infant Risk Center (2020), little or none of the components of the vaccine would ever reach the milk compartment or even be transferred into human milk. Many experts feel that the current group of vaccines are probably going to be quite safe for breastfeeding parents and the infant may even gain a small amount of IgG from human milk that could benefit the infant as well (Infant Risk Center, 2020). The Academy of Breastfeeding Medicine (2020) explains that antibodies and T-cells stimulated by the vaccine may passively transfer into human milk; therefore, the infant may be protected from infection with SARS-CoV-2.
As we know that breastfeeding provides passive immunity for infants and that vaccinations in children are more effective in children who are breastfed, we should advocate that families make informed choices about getting the vaccine and continuing to breastfeed.
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