Want to Take the Pressure Off Breastfeeding Moms Like Me? Get Vaccinated
Moms are extending their breastfeeding goals or seeking donor milk to give their babies coveted protection from COVID-19. While we're still learning about immunity through breast milk, the pressure should not fall on individual mothers to protect their newborns—all eligible Americans should get vaccinated so we reach herd immunity for those who cannot get the shot.
Three weeks after giving birth I was ready to throw in the towel on breastfeeding. My son was able to latch from the start, but he just wasn't taking in enough milk. After almost an hour on the breast, my newborn would still beg for a bottle so we would supplement with formula. Before I became a parent, I wholeheartedly believed in the "fed is best" mentality, and I still do. But it feels different when it's your own experience. I thought I should be able to nurse—sure it's hard, but good moms do hard things for their babies, right? But the hourslong feeding sessions were getting to be too much for me. Not to mention nursing was causing my uterus to contract and I was bleeding a lot—enough to send me to the ER for overnight monitoring (Let's talk more about what postpartum really looks like, shall we?). My family and friends supported my decision to quit, but in the back of my mind there was one thing keeping me from parting with the pump: COVID-19.
While the vaccine wasn't available when I first decided to continue pumping to give my son a few bottles of breast milk a day, I knew that its release was on the horizon and pharmaceutical companies were working fast. I figured if I could just keep giving him my milk until I got the vaccine, maybe I would pass along some antibodies to help protect him from the global pandemic. After joining a few breastfeeding Facebook groups and talking to friends, I soon realized I was not the only one thinking this way. My friend with a baby the same age as mine told me she was going to keep nursing until she was two weeks past her second dose of Pfizer. My co-worker, who was vaccinated during her second pregnancy, says she's considering giving some of her breast milk to her toddler after her baby is born later this month. Some moms on Facebook are even discussing relactation, the practice of triggering milk production after you already weaned, to try to give their babies the antibodies. Others are seeking out milk donors.
"I have seen an increase in informal milk sharing—moms who have been vaccinated and/or recently having COVID-19 infection sharing their breast milk to pass on antibodies to others' babies," says Jessica Madden, M.D., IBCLC, medical director at Aeroflow Breastpumps.
What We Know About Antibody Transfer in Breast Milk
While many new moms have always felt pressure and shame around their breastfeeding decisions, it's even more intense during the global pandemic. We want to do what's best for our babies, and for many of us that means doing whatever it takes to get our babies the COVID-19 antibodies. Yet, the facts about antibody transfer through breast milk and subsequent immunity are still not clear enough.
There have been several reports from around the world showing antibodies in the breast milk of moms who were infected with COVID-19 and moms who received the vaccination. "There is also a very recent study of 84 vaccinated breastfeeding mothers from Israel in this month's Journal of the American Medical Association (JAMA) showing that more than 90 percent had COVID-19 IgG antibodies in their breast milk one month post-vaccination," says Dr. Madden. But it's still unknown how much milk needs to be ingested for the COVID-19 IgA and IgG antibodies to pass from the mother to the baby, she adds. We also don't know how long any possible immunity will last in the baby. Researchers have suggested that the protection acts more like a pill than the vaccine, and the protection only lasts hours or days after the last bottle.
It Takes a Village
It's easy to see how moms feel this pressure to keep breastfeeding to protect their baby from COVID-19, but there could be another solution: herd immunity.
"Even if you are not breastfeeding, getting vaccinated can play a big role in protecting your baby from getting the virus," says Dr. Madden. "It is not necessary to go to heroic measures to relactate or obtain breast milk from vaccinated family members or friends."
Still, protecting those who cannot receive the vaccine, including newborns and babies, should not fall exclusively onto the parents—it needs to be a community effort. In most states, all individuals 16 and up have access to the COVID-19 vaccine already or soon will. As inoculation numbers rise, so does the hope that we as a country return to normal life.
"Once we have reached herd immunity, there will be a marked decrease in community spread of COVID-19, which will lead to a much lower risk of transmission within households," says Dr. Madden. "Most newborn viral infections are from other family members [such as] older school-aged siblings."
A Glimmer of Hope
I'm officially four weeks past my second dose of Moderna. I'm down to two short pumps a day and I'm very ready to fully wean, but I can't help but wonder if my 5-month-old has any protection. Am I being selfish for not pumping for longer?
Vaccine trials are in the works for babies as young as 6 months old, but it's still unknown when it will be safe for him to be vaccinated. Without ability to have him wear a mask, my son hasn't been inside a store or restaurant and we only spend time indoors with people in our bubble—who are now all fully vaccinated. I'm watching with hope as the vaccine numbers in my state rise, praying herd immunity will hit by the time the weather warms up. But still, too many eligible adults refuse the shot based on false information and unfounded concerns. Again, the pressure to protect my baby from a pandemic feels like it's on me and my breasts.