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Is it safe for mothers with COVID-19 or who have taken the vaccine to breastfeed?

Experts agree that breastfeeding is still considered safe for infants and young children even when mothers are suspected or known to have COVID-19. The numerous benefits of breastfeeding substantially outweigh the potential risks of illness associated with the virus and the virus has not been shown to transmit through breast milk. Therefore, it is recommended that mothers continue to breastfeed their infants and young children even if they suspect or know they have COVID-19.

As a support to nutrition specialists and humanitarian actors of all kinds, the IFE Core Group , UNICEF  and the COVID-19 Infant Feeding Working Group  have compiled a resource which answers the most frequently asked questions about the safety of breastfeeding while infected with COVID-19, including:

Should women currently breastfeeding or providing expressed milk receive the vaccines?

Yes. The World Health Organization (WHO) recommends that  lactating woman can safely receive a vaccination. If you are breastfeeding, you should get vaccinated against COVID-19 as soon as it is your turn. None of the current COVID-19 vaccines have live virus in them. This means there is no risk of you transmitting COVID-19 to your baby through your breastmilk from the vaccine.  In fact, the antibodies you get after vaccination may go through your breast milk and help to protect your baby. 

What advice should women currently breastfeeding or expressing milk receive regarding the vaccine?

Lactating women considering the COVID-19 vaccine should have access to information about the safety and efficacy of the vaccine including that:

  • Breastfeeding is vital to the health of infants and their mothers.
  • Vaccine efficacy in lactating women is expected to be similar to efficacy in non-lactating women.
  • There is no data on the safety of mRNA vaccines such as the COVID-19 vaccines on lactating women or their breastfeeding children. However, as the vaccine is not a live virus vaccine and the mRNA does not enter the nucleus of the cell of vaccinated individuals and is degraded quickly, it is biologically and clinically unlikely to pose a risk to the breastfeeding child or child receiving expressed human milk.
  • For the AZD1222 vaccine and the Ad26.COV2.S vaccine, it is unknown whether the vaccine is excreted in human milk, however, as these are non-replicating vaccines, it is unlikely to pose a risk to the breastfeeding child.

It is important to continue to provide the necessary counselling and support for breastfeeding women to build confidence in the safety and adequacy of breastfeeding and risks of not breastfeeding in the context of COVID-19.

Is it safe for mothers to breastfeed after they are vaccinated?

Yes. For Pfizer-BioNTech and Moderna mRNA-1273, the WHO SAGE clarifies that: “As the vaccine is not a live virus vaccine and the mRNA does not enter the nucleus of the cell and is degraded quickly, it is biologically and clinically unlikely there is a risk to the breastfeeding child.”  For AZD1222 and Janssen Ad26. COV2.S, they say "as the vaccine is a non-replicating vaccine, it is unlikely to pose a risk to the breastfeeding child." Therefore, mothers who are vaccinated should be encouraged to continue breastfeeding to protect their infants.

Does the ability to continue breastfeeding or provide expressed milk change or affect milk supply after a mother is vaccinated?

It is highly unlikely that vaccination will have any impact on women’s ability to make milk. The WHO SAGE does not recommend stopping breastfeeding after vaccination. Women currently breastfeeding or expressing milk should continue after receiving the vaccine and can be confident that vaccination will not affect their milk supply. Taking the vaccine should not be an impediment to beginning breastfeeding or a cause for its interruption.

Should breastfeeding health workers who opt not to be vaccinated be prioritized for PPE or given assignments with a low risk of exposure?

Governments and employers are urged to put measures in place to minimize the risk of COVID-19 exposure for health workers who breastfeed through adequate protection at the workplace. It is important that employers and governments prioritize the provision of Personal Protective Equipment (PPE) and lower-risk assignments to health workers who are lactating.

 

Building on the International Labor Organization Standards, how can employers ensure that workers who are breastfeeding or expressing milk but have not received the COVID-19 vaccine maintain their jobs and are protected from any undue consequences?

 

Governments and employers must respect and uphold the right of women to breastfeed. Workers who are currently breastfeeding should not be forced to leave employment if not vaccinated. They should be supported to remain employed and incentivized to continue breastfeeding whether they receive the vaccine or not.

Should there be research undertaken on the vaccination of breastfeeding women?

WHO SAGE acknowledged the lack of data for recommending the vaccine to lactating women. Given the importance of breastfeeding, researchers are encouraged to prioritize this topic and provide data on the safety of these vaccines for breastfeeding mothers and their infants.

 

If you need more information on COVID-19 and Nutrition in emergencies you can access our COVID-19 page. You can find our more information through our  IYCF-E  page.

Do you have specific technical questions you need help with your work? Request support from one of our nutritional specialists.

 

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