The COVID Vaccine and Breastfeeding: What Nursing Moms Need to Know
Experts recommend that nursing women receive the COVID-19 vaccine, even though they’ve been excluded from clinical trials. Here’s what you need to know about the benefits, side effects, and other safety data.
After months of anticipation, three COVID-19 vaccines have finally received emergency use authorization from the Food and Drug Administration (FDA). Two of the vaccines, Pfizer and Moderna, have success rates of more than 94 percent, while Johnson & Johnson is about 72 percent effective in America. The vaccines are currently being distributed to healthcare workers and high-risk individuals across the country.
The quick turnaround leaves many people hopeful that the end of the pandemic is in sight. But some inviduals have doubts about the safety of the vaccine—and that includes breastfeeding mothers, who have largely been excluded from clinical trials. We spoke with experts to learn everything you need to know about the COVID-19 vaccine for breastfeeding women.
Can Breastfeeding Moms Get the COVID-19 Vaccine?
The short answer? Yes. Most experts and organizations recommend that breastfeeding women receive the COVID-19 vaccine. Still, you should consult your healthcare provider to weigh the benefits and risks.
Because the vaccine is still new, we don't yet have much data specific to nursing mothers, says Nicole Calloway Rankins, M.D., MPH, a board-certified OB-GYN Physician, host of the All About Pregnancy & Birth podcast, and member of the Lansinoh Clinical Advisory Network. "But we have learned that overall the vaccine is very well tolerated with minimal side effects. We've also learned that the second dose of the vaccine (for Pfizer and Moderna) is more likely to cause side effects like fatigue, muscle aches, and fever. These usually resolve in 24-36 hours."
The available research suggests that nursing women don't have any more adverse outcomes than anyone else, adds Henry C. Lee, M.D., Associate Professor of Pediatrics and member of the Lansinoh Clinical Advisory Network. "As more people get vaccinated, there will be further tracking of any potential adverse side effects," he adds.
"With the vaccine, you're accepting the risks of side effects, which thus far we know to be minimal. Without the vaccine, you're accepting the risks of getting COVID, which we know can potentially be devastating," says Dr. Rankins.
It's also important to note that ACOG and the Academy of Breastfeeding Medicine (ABM) recommend that breastfeeding women get vaccinated. According to the ABM website, "While there is little plausible risk for the child, there is a biologically plausible benefit. Antibodies and T-cells stimulated by the vaccine may passively transfer into milk. Following vaccination against other viruses, IgA antibodies are detectable in milk within 5 to 7 days. Antibodies transferred into milk may therefore protect the infant from infection with SARS-CoV-2."
Why Haven't Breastfeeding Mothers Been Included in Vaccine Trials?
"Pregnant and breastfeeding women are almost always excluded from clinical trials, so it's not unusual," says Dr. Rankins. That's because experts don't fully understand the risks to babies, who might be affected through a mother's breast milk.
Some organizations, such as the American College of Obstetricians and Gynecologists (ACOG), advocate that this standard should be changed. They believe "pregnant and lactating individuals should be given the opportunity to participate, and not have that decision made for them," says Dr. Rankins. But for now, the only safety data we have is from breastfeeding healthcare personnel and essential workers who received the vaccine through emergency use authorization.
What Are the Benefits of Getting the COVID-19 Vaccine While Nursing?
Breastfeeding parents must decide for themselves whether to get vaccinated—and that involves weighing the benefits against the risks. "The benefit of getting the vaccine is primarily that the breastfeeding woman will potentially gain protection from either getting COVID-19 or have less severe disease if they do get COVID-19, so that they can continue to care for their infant," says Dr. Lee. What's more, "based on what we know about other vaccines, we believe that the antibodies that mom produces will pass through the breast milk and may confer protection for the baby," says Dr. Rankins.
Both the Pfizer and Moderna vaccine require two doses—you receive Pfizer's second dose three weeks after the first dose, and Moderna's four weeks afterward. After your body builds sufficient immunity (about two weeks about the second dose), you'll have about 94 percent protection against COVID-19. The Johnson & Johnson vaccine, on the other hand, requires one dose, and it's about 72 percent effective in America. The coronavirus can be life-threatening in severe cases, so the vaccine could potentially spare the lives of a mother or her baby.
How Should I Make the Decision?
Still unsure about whether to get the COVID-19 vaccine while breasting? Start by checking out the Centers for Disease Control and Prevention (CDC) website, which has a wealth of information about the vaccines. Also, "when considering whether to get the vaccine while breastfeeding, it's important to ask your healthcare provider in the context of your own personal risk," says Dr. Rankins. "For example, if you have underlying health problems like diabetes, high blood pressure, or lung disease that increase your risk of having a more severe form of COVID, you may be more inclined to get the vaccine while breastfeeding." You may also be more willing to get vaccinated if you have a high-risk job (like if you're a teacher, nursing home worker, healthcare worker, grocery store cashier, etc.)
It may also help to look at how breastfeeding women respond to similar vaccinations. "We know that other vaccines given while breastfeeding are exceedingly safe with very minimal risks to moms or babies," says Dr. Rankins. "There is nothing about the COVID vaccine that leads us to believe that it will be any different." Plus the COVID vaccine is an mRNA vaccine, meaning that no dead or alive COVID-19 viruses are being put in your body. In other words, mothers and their babies can't get infected with the coronavirus through the vaccine.
The Bottom Line
You likely should get the COVID-19 vaccine, even if you're breastfeeding. While organizations and experts recommend vaccination, it's best to check with your healthcare provider. "This disease is devastating and these vaccines will help stop it, but only if enough of us get it," says Dr. Rankins.