COVID-19 Vaccine Safety if Breastfeeding- Pediatrician and Lactation Consultant Discusses the Data

Pediatrician and Lactation Consultant Dr. Amna Husain weighs in on the safety of the Covid 19 Vaccine if you are breastfeeding and covers the data we have on breastfeeding while COVID positive. Those who are breastfeeding are concerned about the safety, but we have extensively studied mRNA and also have seen breastfeeding persons positive for COVID 19 continue to feed their babies. For further reading and resources: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2772176 https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/vaccinating-pregnant-and-lactating-patients-against-covid-19 https://www.bfmed.org/abm-statement-considerations-for-covid-19-vaccination-in-lactation Timecodes: 0:00 - Intro 2:01 - What is an mRNA vaccine? 3:40 - How does the vaccine work? 4:24 - Is there a plausible risk of a breastfeeding woman getting the vaccine? 5:29 - Can COVID-19 positive women continue to nurse? 7:40 - Is there a plausible benefit of breastfeeding woman receiving the vaccine? 10:00 - Busting Covid vaccine myths To see my other content, follow me- Instagram: https://www.instagram.com/dr.amnahusain/ Tiktok: https://www.tiktok.com/@dr.amnahusain?lang=en ***The information in this video is intended to serve as educational information and can not be construed as a substitute for professional medical advice, diagnosis, or treatment of you or your child. Content within this video is for information purposes only and does not replace a consultation with your own doctor or your child's doctor.

TRANSCRIPTION

Dr. Amna Husain: Hello, everyone. Welcome back. This is Dr. Amna Husain. I'm a board-certified pediatrician, board-certified lactation consultant, and mom. Today, we're actually going to be talking about something that's been in the headlines for a couple of weeks now, and it's the COVID-19 vaccine and its safety for lactating or breastfeeding women. So as a pediatrician, I of course take care of breastfed infants, toddlers, and children. And as a lactation consultant, I often have lactating and breastfeeding mothers as my patient. For the scope of this video, we're not going to focus in on pregnancy, pregnant women, and the safety of the vaccine. That's just not my scope of work. I'm not an OB-GYN. I don't provide prenatal advice, but I will be linking below ACOG, or the American College of Obstetrics and Gynecology statement, which does provide a lot of guidance on the vaccine and pregnant women.

The second point I really want to make is this data is prevalent as of January 6th, 2021, which is when I filmed this video. There may be changes going forward if you watch this months from now, years from now, even, but this is data as of today, January 6th, 2021. The third point I want to make, this is in no way me trying to convince you to receive the vaccine. That's not my job, and that's not my point and purpose here. My purpose is to provide the evidence, the data, and the understanding of science and biology that we know right now when it comes to the physiology of breastfeeding, the biology of vaccines and their effects on the human body, and when it comes to lactation. This is data that you can take with you. Definitely look at the sources below. But take it with you to your doctor and have an informed discussion and make a decision with them personalized to your context, your environment, and your medical history, your medical profile.

All right, so let's get started. First of all, I want to point out that this is in regards to the two MRNA vaccines that are improved as of today, January 6th, 2021. Those are from the companies Pfizer and Moderna. So, the two vaccines are two-dose series. That means you're going to need to get two shots. For Pfizer, it's going to be 21 days apart, and for Moderna, they're going to be 28 days apart. Now, let's talk about, let's say, mRNA, because I know a lot of people have some concerns about the risks of it, and questions about the safety of this vaccine. First of all, let's bust one myth, that the mRNA is not going to change your DNA. That's just not the way it works. The DNA lives in your cells nucleus, and that's not really where the mRNA is going at all. So, that's completely a myth.

The second point, in terms of mNRA being new. This is the first mRNA vaccine, but this is not the first time we've ever worked with mRNA technology. Scientists have been working with mRNA technology for a number of years. The great thing about this vaccine is we've learned a great way to deliver it into the body without it degrading so rapidly that it can't do the job we want it to do. And we do that by actually encapsulating, or really covering the mRNA or the genetic blueprint, let's say, for this component of the virus, in a lipid or a fatty nanoparticle. That vaccine gets delivered IM, or intramuscular, into the body. Right now, Pfizer is approved for 16 and over, and Moderna is approved for 18 and up.

The vaccine is delivered intramuscularly. The mRNA serves, again, as a genetic blueprint to really create just that one specific part of the SARS-CoV-2 virus. That's the spike protein, the immunogenic part of the virus, that our body's going to see, say, "Whoa, what is this?", mount an immune response, and create antibodies. That's really how the vaccine is working in our body, so that theoretically, if we encounter the SARS-CoV-2 virus again, our body can ramp up with that immune response that we've already seen, and present the virus with antibodies, make sure we can quash it out. Okay?

Let's talk about, in general, the risk, if there was a plausible risk. Let's say the mRNA gets into our bloodstream, and then that's how it would theoretically get into the breast milk, and you are nursing your little one. Your little one would ingest that mRNA protein, and then digest it, and break it down, and excrete it. That's really the only thing that would happen. It wouldn't really have a chance to mutate or cause COVID-19 to occur in your child. And the reason we know this is because we actually have COVID-19-positive moms who breastfeed. We studied this virus very early on in March and April, when we were seeing a number of COVID-19-positive mothers. We took breast milk samples from breastfeeding moms, and checked it and tested it for the virus.

We also know that breastfeeding is not the primary mode of transmission for this virus. It's respiratory transmission. It's droplet transmission. We can actually have COVID-19 positive moms breastfeed. There's two ways that they can do this. This is for the mother who is sitting at home overall feeling well. She's not, for instance, in the hospital on oxygen or on IV medications or on lifesaving support at the moment. Because yes, sometimes those medications, those IV drugs, may be unsafe and the mom is definitely not in potentially a good place for a health status standpoint to be able to hold her infant or nurse her infant.

So this is for the mom who is overall healthy sitting at home, combating this COVID-19 infection. There's two ways. First one, wash your hands, put on a mask and then wash her breasts. So if she's feeding from the left and the right, wash both breasts and then bring infant to the breast. The infant should not be wearing a mask. If the infant is less than two, we don't need masks on children that young. Now, you can feed the infant. There's no risk of necessarily transmitting COVID-19 through the breast milk. Of course there's a risk of transmitting disease because you're within six feet contact, and again, respiratory droplet transmission. That's where the mask is crucial. Now, if you decide not to take that risk because you're within six feet, there's a second way that you can definitely breastfeed your infant if you're a nursing mom.

You can pump and then provide that pumped milk to another member. It could be your significant other or a family member who is taking care of your infant while you're isolating away, while you've been positive with COVID-19 and you're working on recovering. Your pump parts will need to be sterilized. Of course, before you pump, you wash your hands. The same things that we've already discussed, but that is still another way that you can provide breast milk to an infant while you're COVID-19 positive.

As a physician, a lactation consultant, and as a mom, those are really reassuring things that we actually can have a positive mom with an active infection, be able to breastfeed without possibly passing on COVID-19. That makes me feel even better about there being a very little plausible risk to getting really the vaccine and continuing to breastfeed.

But let's talk about the plausible benefit because there definitely is one, and that's antibodies. When you receive the vaccine, or if after you get the infection, your body does mount an immune response and you do have antibodies. There's a specific type of antibody that gets transferred in breast milk, and that's called IGA or immunoglobulin A. Those antibodies can go on to protect your infant if they were to encounter the virus. There is definitely plausible benefit.

Now there's two definitely medical organizations that I recommend you check out their statements and I'm going to attach them in the show notes, but it's the American College of Obstetrics and Gynecology, or ACOG, which I've already mentioned, and the Academy of Breastfeeding Medicine, or ABM. They have really great data. And again, I think those are great resources. I'm going to reiterate that this is not my place for me to make this decision for you. I just want to provide guidance and data of what we know right now.

But it's up to you to really weigh the risks and benefits with your doctor and make an informed decision within the context of you contracting this disease. What does that mean? Well, if you're pregnant, excuse me, a nursing healthcare worker and you're on the front lines, you're seeing patients, you are in the ER, you're in the ICU, you're swabbing, you're testing patients, or you're working in the hospital and you're around COVID-19 positive people, your risk is definitely different and higher than let's say a nursing mom who is able to work from home luckily and work virtually, limit her contact with other individuals and really abide by stay at home orders in a way, because she's not necessarily an essential personnel who needs to go into her job. So, those two contexts are very different.

And talking to your doctor about your risks of contracting the disease, if you are on the fence about getting the vaccine, those are definitely important things to consider. So again, this is not for me to make the decision for you. This is for me to provide you guidance and the risks, the benefits, the context of you contracting the disease, with your doctor. That's a decision you have to make.

Two other myths I want to bust for you guys. The first one is going to be, do you have to prematurely wean? I've heard this a lot. For example, let's say you have a nursing mom and she has a four month old or a six month old, and she really wants to get this vaccine, you do not have to prematurely wheen. You can continue to breastfeed. Second, you do not need to pump and dump. I understand that some mothers may feel more comfortable, and that is again, a decision you choose to make. If you choose to prematurely wean, if you choose to pump and dump, that's your decision, but there is nothing scientifically proven or shown that you need to actually pump and dump after you get this vaccine.

So again, I hope this answers some questions for you all. I hope this is able to lay some myths and misconceptions, concerns to rest. Please make sure you check out the show notes. If you did enjoy this episode, please make sure you like it. Make sure you subscribe. I'm going to be trying to focus in more on COVID-19 updates as we go forward, which I do anticipate there will be more of, especially as we learn more about the trials and when it's safe for children to take it. As of now, Pfizer is approved for children 16 and up, and Moderna is approved for really children or young adults, 18 and up. So we'll hopefully have more data in the coming months, and I will, of course share that with you. I hope you guys have a good day. Bye.