The COVID Vaccine and Breastfeeding: What Nursing Parents Need to Know

When you're breastfeeding, you're exceedingly careful about every little thing you put in (or on) your body, from the foods you eat to skin lotion. Now you're facing a new challenge, wondering whether it's really OK to get the COVID-19 vaccine. Well, here's the good news: Most health care providers say it's completely safe to get the shots while nursing; in fact, doing so will offer your baby an extra level of protection. You may still be doubtful, so we asked the experts to address your biggest worries.

Should Breastfeeding Parents Get the COVID-19 Vaccine?

The short answer? Yes. The Centers for Disease Control and Prevention (CDC), American College of Obstetricians and Gynecologists (ACOG), and the Academy of Breastfeeding Medicine (ABM) currently recommend that people who are breastfeeding receive the COVID-19 vaccine, or do not stop breastfeeding if they've gotten it. As these organizations note, there is little chance it could be harmful and it may benefit your baby. Still, you should consult a health care professional to weigh the pros and cons.

The CDC says that the Pfizer and Moderna vaccines and boosters are preferable to the shot released by Johnson & Johnson, which might be acceptable "in some situations." None of the vaccines have a live virus inside them, so neither parents nor babies can be infected with the coronavirus from the shots.

If your baby is under the age of 1, or if you were recently pregnant, each of you has greater odds of becoming seriously ill after contracting COVID-19. That's not something to ignore. "With the vaccine, you're accepting the risks of side effects, which thus far we know to be minimal," says Nicole Calloway Rankins, M.D., MPH, an OB-GYN and host of the All About Pregnancy & Birth podcast. "Without the vaccine, you're accepting the risks of getting COVID, which we know can potentially be devastating."

To be fair, the vaccines are new, and so there isn't much data specific to nursing mothers, admits Dr. Rankins. "But we have learned that overall the vaccine is very well tolerated, with minimal side effects," she adds. The mechanism that makes it work does not usually present safety issues to someone breastfeeding, or their child; more common vaccines (including those for measles, mumps, and rubella; tetanus, diptheria, and pertussis; and chickenpox) do not negatively affect breast milk, either.

Stanford pediatrics professor Henry C. Lee, M.D., says that people who breastfeed do not have more adverse events than anyone else. "As more people get vaccinated, there will be further tracking of any potential adverse side effects," he notes.

It's already happening: In a September 2021 Breastfeeding Medicine study of 180 lactating people, subjects who had been vaccinated had no side effects that differed from non-lactating people, and their infants suffered no serious adverse events Note, however, that "a small proportion of women following the first dose of either vaccine brand reported a reduction in milk supply, and significantly, more women reported a reduction in milk supply following the second dose of Moderna," notes the study. That said, milk production returned to normal within 72 hours in all cases.

Anyone who is currently breastfeeding may also be comforted by a July 2021 study conducted at the University of California, San Francisco. Researchers collected 13 breast milk samples from seven parents, up to 48 hours after they received the Pfizer or Moderna vaccines. Their results showed that "vaccine-associated mRNA" wasn't detected in the samples. Other studies echo those findings. "These results provide important early evidence to strengthen current recommendations that vaccine-related mRNA is not transferred to the infant and that lactating individuals who receive the COVID-19 mRNA-based vaccine should not stop breastfeeding," wrote the study authors.

Why Weren't Breastfeeding People Included in Vaccine Trials?

"Pregnant and breastfeeding people are almost always excluded from clinical trials, so it's not unusual," says Dr. Rankins. That's because experts don't fully understand the risks to babies, who might be affected by a medication in their parents' breast milk. Some organizations, such as ACOG, advocate for changing this standard. They believe "pregnant and lactating individuals should be given the opportunity to participate, and not have that decision made for them," explains Dr. Rankins.

What Are the Benefits of Getting the COVID-19 Vaccine While Nursing?

Breastfeeding parents must decide for themselves whether to get vaccinated—but experts say there are many reasons to do it. "The benefit of getting the vaccine is primarily that the breastfeeding person will potentially gain protection from either getting COVID-19 or have less severe disease if they do get COVID-19, so that they can continue to care for their infant," says Dr. Lee.

What's more, "based on what we know about other vaccines, we believe that the antibodies that mom produces will pass through the breast milk and may confer protection for the baby," says Dr. Rankins. Indeed, according to the CDC, "Recent reports have shown that breastfeeding people who have received COVID-19 mRNA vaccines have antibodies in their breast milk, which could help protect their babies. More data are needed to determine what protection these antibodies may provide to the baby."

Both the Pfizer and Moderna vaccines require two doses and a booster. You receive Pfizer's second dose three weeks after the first dose, and Moderna's four weeks afterward, with boosters for both given at least five months later. The Johnson & Johnson vaccine, on the other hand, requires one dose, with a booster two months later. Some individuals are also eligible for a second booster shot. After you are fully vaccinated, you'll have strong protection against severe illness. The coronavirus can be life-threatening, so this could spare the lives of parent and baby.

How Do I Make My Decision?

Still unsure about whether to get the COVID-19 vaccine while breastfeeding? Start by checking out the CDC website, which has a wealth of information about the vaccines. Also, "when considering whether to get the vaccine while breastfeeding, it's important to ask your health care provider in the context of your own personal risk," says Dr. Rankins. "For example, if you have underlying health problems like diabetes, high blood pressure, or lung disease, which increase your risk of having a more severe form of COVID, you may be more inclined to get the vaccine while breastfeeding." You may also consider it if you have a high-risk job (as a teacher, nursing home worker, or health care worker, for example.)

The Bottom Line

Experts and medical organizations recommend that everyone age 6 months and up receive the COVID-19 vaccine—and that still holds true, even if you're breastfeeding. "This disease is devastating and these vaccines will help stop it, but only if enough of us get it," emphasizes Dr. Rankins. If you remain concerned, consult a health care professional for advice—they'll likely put your worries to rest.