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5 Things to Know about the COVID-19 vaccine and breastfeeding

By Dr. Kristina Adams Waldorf, Sara Rutz, Isabelle Crary and Carly Baxter

Knowing if and when to get the COVID-19 vaccine can be daunting, especially when you’ve just had a baby. Many breastfeeding individuals are unsure whether to get the COVID-19 vaccine while breastfeeding and it can be challenging to keep up with all the new incoming data surrounding the vaccine. 

Below are several key takeaways about COVID-19 vaccine and breastfeeding, grounded in the latest medical research.

The COVID-19 vaccine is safe and recommended while breastfeeding. 
The CDC recommends that individuals who are breastfeeding get the COVID-19 vaccine or booster. It is safe for you and your baby to get the COVID-19 vaccine while breastfeeding. The vaccine does not contain live parts of the COVID-19 virus, meaning the vaccine cannot cause COVID-19 infection in you or your baby. The ingredients of the Pfizer and Moderna vaccines are also known to be safe. They DO NOT include preservatives, antibiotics, tissue, or common allergens such as food proteins, metals or latex. While many have voiced concerns about the speed of vaccination production, the COVID-19 vaccinations offered in the US have undergone the most rigorous safety monitoring in history. 

Antibodies from the COVID-19 vaccine transfer through breast milk and can protect your baby. 
Breast milk offers much more than nutrition and has long been known to protect infants against numerous infections by passing protective antibodies from the mother to the infant. Recent studies have shown that protective antibodies against COVID-19 transfer in breast milk following COVID-19 vaccination of the pregnant person. These antibodies may help protect your baby from COVID-19 infection. Both ACOG (American College of Obstetricians and Gynecologists) and SMFM (Society for Maternal Fetal Medicine) recommend COVID-19 vaccination in pregnant people. 

People who are breastfeeding do not have serious side effects from the vaccine. 
People who are breastfeeding and receive the COVID-19 vaccine generally experience the same mild symptoms as individuals who are not breastfeeding, including pain at injection site, chills, and fatigue.  A small number of breastfeeding individuals reported a temporary reduction in breast milk production, but all breastfeeding individuals returned to their normal milk production within 72 hours of receiving the vaccine. There were no serious reactions to the vaccine in breastfeeding infants, although a small percent did develop mild symptoms such as irritability and poor sleep. 

You do not need to stop breastfeeding to get the COVID-19 vaccine. 
‍ACOG and SMFM recommend that you do not stop breastfeeding when you get the COVID-19 vaccine.  Breast milk can help protect your baby from many infections, not just COVID, and is an important source of nutrients for your baby. Babies have weaker immune systems than adults, and pausing breastfeeding to get the vaccine prevents your baby from getting essential nutrients and antibodies that are essential to fighting off infections. In addition, altering your regular breastfeeding schedule can cause a decrease in breast milk production and increased feeding challenges when you re-initiate breastfeeding. 

Severe COVID-19 infection can make breastfeeding more difficult. 
Mild COVID-19 infections do not limit breastfeeding and breastfeeding individuals should not stop breastfeeding with the COVID-19 infection. Preliminary data suggests that COVID-19 infection is unlikely to be transferred through breast milk, however, COVID-19 is spread through respiratory droplets meaning that infants can still get COVID-19 from being in close proximity to an infected mother during breastfeeds. Current guidelines suggest that mothers with COVID-19 wear a mask and wash hands frequently when directly caring for their infants. While there is no data to suggest that COVID-19 directly affects breast milk supply, having severe COVID-19 disease, especially if you are hospitalized, can make it difficult to properly care for and feed a new infant. Getting the COVID-19 vaccine is the most effective way to prevent severe COVID-19 infection and minimize the risk of the COVID-19 infection-related challenges with breastfeeding. 

‍If you have more questions, please visit our homepage, www.OneVaxTwoLives.com

Meet the Authors

Kristina Adams Waldorf, MD

Kristina Adams Waldorf, MD is a Professor of Obstetrics and Gynecology and Adjunct Professor of Global Health at the University of Washington School of Medicine. She is an internationally recognized expert in how infections impact pregnancy and how vaccines and therapeutics protect the mother and fetus. She is Chair of the National Institutes of Health Obstetrics and Maternal-Fetal Biology Study Section. She is a member of the Center for Reproductive Sciences and the Center for Innate Immunity and Immune Diseases. Her grant support has come from the National Institutes of Health, the March of Dimes, Burroughs-Wellcome Fund, the Canadian Institute for Health Research and the Australian National Medical Research Council.

Sara Rutz

Sara Rutz graduated from the University of Alaska, Anchorage with a Bachelor of Science degree in Natural Sciences and a minor in Psychology. She is now a third year medical student at the University of Washington School of Medicine. Prior to medical school, she worked with diverse & underserved populations in patient care settings and as an insurance specialist for 5 years. She has been involved in research on improving outcomes for infants with Neonatal Opioid Withdrawal Syndrome, quality improvement in obstetric care, and providing up to date information as a volunteer for the COVID-19 Literature Surveillance Team. She is passionate about reproductive medicine and improving access to care for rural and underserved populations.

Carly Baxter

Carly Baxter graduated from the University of Puget Sound with a Bachelor of Science degree in Biology and a minor in French studies. She is now a 2nd year medical student at the University of Washington School of Medicine. She has worked with the MaMHA (Maternal Mental Health Access) group coordinated by the University of Washington and WA Department of Health in an effort to reduce maternal mortality rates in WA state. She is passionate about reproductive justice, equitable health care access and volunteering within her community at local health fairs.

Isabelle Crary

Isabelle Crary graduated from Stanford University with a Bachelors of Arts in Human Biology. She is now a second year medical student at the University of Washington. She has been involved in research on anemia in pregnancy, breast cancer prevention and treatment, and adolescent nutrition. She is passionate about healthcare for individuals who are pregnant, reproductive justice and nutrition education.