Can breastfeeding women get Covid jabs?

Breastfeeding is safe for infants and young children even when the 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. Breastfed babies have not been shown to be at risk of transmission of Covid-19 virus through breastmilk. Consequently, the World Health Organisation (WHO), Centers for Disease Control and Prevention, International Federation of Gynaecology and Obstetrics, American College of Obstetricians and Gynecologists and the Royal College of Obstetricians and Gynecologists recommend that mothers continue to breastfeed their infants if suspected or known to have Covid-19.
The WHO Scientific Advisory Group of Emergencies (SAGE) recommends that if a breastfeeding woman is part of a ‘high risk group’ e.g. health worker, frontline worker, or has comorbidities or is part of a group recommended for vaccination, vaccination can be offered. Healthy women currently breast-feeding or expressing milk can also receive the vaccines according to the CDC, FIGO and other organisations. Breastfeeding is vital to the health of infants and their mothers.  At the start, clinical trials for the Covid-19 vaccines in emergency use currently did not include women who are breastfeeding. Since the vaccines have not been studied on breastfeeding women, there are no data available on the safety of Covid-19 vaccines in lactating people, effects of vaccination on the breastfed baby and effects on milk production or excretion. However, based on how these vaccines work in the body, there is no plausible mechanism by which any vaccine ingredient could pass to the woman’s’ baby through breast milk. Therefore, lactating women can receive a Covid-19 vaccine.
Recent reports have shown that breastfeeding women who have received Covid-19 vaccines have antibodies in their breastmilk, which could help protect their babies. However, more data are needed to determine what protection these antibodies may provide to the baby.
Breastfeeding women considering receiving 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 yet on the safety of Covid-19 vaccines on lactating women or their breastfeeding children. However, since none of the Covid 19 vaccines is a live virus vaccine, it is biologically and clinically unlikely to pose a risk to the breastfeeding child or child receiving expressed human milk.
It is therefore important for us 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.
For Pfizer and Moderna vaccines, 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,”
 With AstraZeneca and J & J vaccines, the vaccine is a non-replicating, it is also unlikely to pose a risk to the breastfeeding child.” Therefore, mothers who are vaccinated should be encouraged to continue breastfeeding to protect their infants.
It is highly unlikely that vaccination will have any impact on women’s ability to make milk. Various organizations such as WHO, CDC among others do 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 begin breastfeeding or a cause for its interruption.
We acknowledge the lack of data for recommending the vaccine to lactating women but the tremendous benefits of breastfeeding substantially outweigh the potential risks of illness associated with the virus. However, researchers are encouraged to prioritise this topic of Covid-19 vaccination in breastfeeding women and provide data on the safety of these vaccines for breastfeeding.
Ms Lilian Nuwabaine Luyima is a BSc trained Nurse; Midwife & Women’s Health Specialist