COVID-19 vaccination and breastfeeding
COVID-19 vaccines can be given to anyone who is breastfeeding.
There is no known risk associated with giving non-live vaccines during breastfeeding, including COVID-19 vaccines. Therefore, those who are breastfeeding should be offered the COVID-19 vaccine if they are eligible.
Detection in breast milk
Although small quantities of COVID-19 mRNA have been detected in some breast milk samples after vaccination, there is no evidence that this survives the infant gastro-intestinal tract, or that it causes any infant harm. Limited data show no vaccine components in infant serum after breast milk exposure.
The vaccine may protect the infant
The UK Health Security Agency (UKHSA) Immunisation Against Infectious Disease (the Green Book) confirms that emerging safety data are reassuring and antibodies and T-cells have been detected in breast milk after vaccination, which may help to protect the infant. The milk antibody response appears to be weaker if non-mRNA vaccines are used.
Infant monitoring
Side effects in the breastfed infant from exposure to the vaccine through breast milk are highly unlikely. As a precaution, monitor for fever, drowsiness, irritability and gastro-intestinal disturbances. These should be self-limiting; contact a healthcare professional if there are any concerns.
Further information
Patient information is available from the UK Health Security Agency (UKHSA) .
General advice regarding COVID-19 vaccination is available, including other safety issues to consider.
Breastfeeding with COVID-19 infection
Breastfeeding should continue as normal.
Although the COVID-19 virus has been detected in breast milk samples, its viability has not been confirmed. There is no evidence to show that the presence of the virus in milk causes infection in breastfed infants.
There is evidence that maternal antibodies, generated in response to COVID-19 virus, and other bioactive factors, do pass into breast milk. This can help protect the infant.
Minimising risk of infant infection through close contact
In order for breastfeeding to be facilitated it is important that mother and baby stay close together. However, consider the following to reduce the risk of the infant becoming infected:
- Wash your hands for at least 20 seconds before touching the infant or any expressing equipment
- avoid coughing or sneezing on the infant while breastfeeding
- consider wearing a face mask whilst breastfeeding
- if used, clean breast pumps as recommended by the manufacturer after each use.
Treating COVID-19 infection
The treatment of COVID-19 remains a dynamic situation. Therefore if a medicine being considered is not listed here, contact the UK Drugs In Lactation Advisory Service (UKDILAS), our specialist medicines in breastfeeding advice service.
Recommendations apply to infants born full term and healthy.
Patient Information
The NHS website provides advice for patients on the use of specific medicines in breastfeeding.
Contact us
Get in touch with the UK Drugs In Lactation Advisory Service (UKDILAS), our specialist breastfeeding medicines advice service if you need support in the following situations:
- you need further advice
- the medicine in question is not included here
- the infant is unwell or premature
- multiple medicines are being taken
About our recommendations
Recommendations are based on published evidence where available. However, evidence is generally very poor and limited, and can require professional interpretation. Assessments are often based on reviewing case reports which can be conflicting and lack detail.
If there is no published clinical evidence, assessments are based on: pharmacodynamic and pharmacokinetic principles, extrapolation from similar drugs, risk assessment of normal clinical use, expert advice, and unpublished data. Simulated data is now increasingly being used due to the ethical difficulties around gathering good quality evidence in this area.
Bibliography
Full referencing is available on request.