With the progress in the vaccination campaign against Covid-19 in our country, there are many mothers who are breastfeeding their babies and are at high risk of contagion when in contact with infected people -such as , health professionals-, or they are people at high risk of complications. Not surprisingly, they are concerned about whether they can safely get vaccinated for themselves and their babies while still breastfeeding.
Given that the vaccines that we have in Spain (Pfizer -Comirnaty en Europa-y Moderna) have not been tested in pregnant or lactating mothers, the mother must make the decision evaluating risks and benefits, after being duly informed.
We are going to summarize what the main national and international organizations say, today, about the Covid-19 vaccine and its compatibility with breastfeeding .
No risk is expected
The data available so far is limited, but most suggest that no risk is expected, considering that these are mRNA (messenger RNA) vaccines, which do not contain the live virus that causes COVID-19.
Although the recommendations may change as new studies become known, none indicate stopping or not starting breastfeeding due to vaccination .
So far, no vaccine is contraindicated during breastfeeding (except for yellow fever – which contains live viruses – if you travel to a risk country), so it is not expected to be, since it is also made without live virus.
About the Covid-19 vaccine in breastfeeding mothers:
CDC (Centers for Disease Prevention Control)
The CDC (Centers for Disease Prevention Control) of the United States mentions:
There are no data on the safety of COVID-19 vaccines in lactating women or on the effects of mRNA vaccines on infants or on milk production / excretion. MRNA vaccines are not believed to pose any risk to infants . People who are breastfeeding and are part of a group recommended to get vaccinated against COVID-19, such as healthcare personnel, can choose to get vaccinated or not.
European Medicines Agency (EMA)
The European Medicines Agency in the frequently asked questions about the Pfizer vaccine on its website, and also about the Moderna vaccine, responds:
Can pregnant or breastfeeding women get the vaccine?
Animal studies do not show any harmful effects during pregnancy, however, data on the use of Comirnaty / Moderna during pregnancy is very limited. Although there are no studies on breastfeeding, no risk is expected for breastfeeding . The decision to use the vaccine in pregnant women should be made in close consultation with a healthcare professional after considering the benefits and risks.
World Health Organization (WHO)
Also specifically about the Pfizer vaccine, on January 8 WHO published in its recommendations (translated):
Breastfeeding offers important health benefits for lactating women and their breastfed children. The efficacy of the vaccine is expected to be similar in lactating women as in other adults. However, there are no data on the safety of COVID-19 vaccines in lactating women or on the effects of mRNA vaccines in breastfed children.
As the BNT162b2 vaccine is not a live virus vaccine and the mRNA does not enter the nucleus of the cell, it is rapidly degraded and it is biological, it is clinically unlikely to pose a risk to lactation .
Based on these considerations, a nursing woman who is part of a group recommended for vaccination, eg healthcare workers, should be offered vaccination on an equivalent basis. WHO does not recommend stopping breastfeeding after vaccination.
Spanish Association of Pediatrics (AEP)
On December 23, the Vaccine Advisory Committee of the AEP published the following recommendations:
Considering the importance of breastfeeding and the accumulated experience with other inactivated vaccines: consider starting normally and not interrupting breastfeeding in women who receive the Comirnaty vaccine, and not delaying vaccination, if indicated, for this reason.
And adds:
Given the need to individualize the application of general rules to special cases, we encourage professionals and women involved to evaluate the advantages and disadvantages of vaccination in the light of the best possible information, and with confidence in the high level of safety shown by this vaccine so far.
e-lactation, reference website
The e-lactancia.org website, made by breastfeeding professionals, which analyzes the compatibility of breastfeeding with about 30 thousand terms, considers the vaccine against Covid-19 as ” Low risk for breastfeeding “, considering that it is fairly safe, probably compatible, and low or unlikely risk:
It is highly unlikely that the components of the COVID-19 vaccines could be excreted in human milk and, in any case, would be digested in the infant’s intestine (InfantRisk 2020/12/18).
It seems reasonable to think that if the disease (COVID-19) is compatible with breastfeeding, the more so will your vaccine , which does not even contain the live virus.
Ministry of Health
On the website of the Covid-19 vaccination strategy created by the Government of Spain.
There are also no data on the possible effects of the vaccine during breastfeeding (neither on milk production nor on the infant), although taking into account the type of vaccines currently authorized (Comirnaty, from Pfizer / BioNTech, and the vaccine against COVID -19 de Moderna) is not considered to pose a risk to the infant , so in the case of breastfeeding women who have a high risk of exposure or high risk of complications, vaccination can be evaluated individually.
Spanish Medicines Agency (AEMPS)
The same is found in the recommendations of the Spanish Agency for Medicines and Health Products:
Laboratory studies in animal models have not shown any harmful effects in pregnancy, however information on the use of Comirnaty in pregnancy is still very limited. Although there are no studies on lactation, no risk is expected .
The decision to use the vaccine in pregnant women or during breastfeeding should be made with the assessment of a health professional to individually assess the benefits and risks in each case.
FACME (Federation of Spanish Medical Scientific Associations)
In the FACME recommendations for vaccination against COVID there is a special mention to nursing mothers:
Vaccination of the mother against COVID-19 is considered safe for the woman herself, for breastfeeding, as well as for the baby :
• Vaccines against COVID-19 based on mRNA do not contain live microorganisms, they do not have infective capacity.
• With the other vaccines, the presence of active vaccine components in breast milk has never been demonstrated (with the exception noted -the yellow fever vaccine-).
• The mother’s health is, finally, a key determinant for breastfeeding and the health of her children.
However, both breastfeeding and vaccination must respond to an informed decision of the mother, who must have the best possible information and, at the same time, be encouraged to reinforce general measures for the prevention of horizontal transmission to the baby and other partners. (hand washing, etc.).
Royal College of Obstetricians and Gynaecologists (UK)
The UK College of Obstetricians and Gynecologists refers to a Joint Committee on Vaccination and Immunization (JCVI) document published on December 30, 2020, which states:
There is no known risk when administering the COVID-19 vaccines available to breastfeeding women.
Breastfeeding women will be offered the vaccination if they are eligible, for example, if they are in a clinically extremely vulnerable group or if they are a front-line health or social care worker, including a caregiver in a residential home. Women should be advised that safety data for these specific vaccines are lacking during lactation.
We hope we have given you an overview of what the leading experts think about the compatibility of the Covid-19 vaccine and breastfeeding , so that you can make an informed decision.
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