Can breastfeeding mothers receive Covid (Coronavirus) and flu (influenza) vaccinations?

COVID-19 and Influenza Vaccination During Breastfeeding

Yes, breastfeeding mothers should receive both COVID-19 and influenza vaccinations—these vaccines are safe for both mother and infant, and vaccination actually provides protective antibodies to the breastfed baby through breast milk. 1, 2

Safety Profile for Mother and Infant

Both influenza and COVID-19 vaccination during breastfeeding are explicitly safe for mothers and their infants according to major medical organizations. 1, 2

• The American Academy of Pediatrics states that influenza vaccination during breastfeeding is safe for mothers and their infants 1
• The American College of Obstetricians and Gynecologists and Academy of Breastfeeding Medicine confirm that COVID-19 vaccination poses minimal to no potential risk to the breastfed infant 2
• Vaccine-related mRNA has not been detected in breast milk studies, supporting the safety of COVID-19 vaccination 2
• Large studies show minimal disruption of lactation, with only 1.7% of mothers reporting any negative impact on breastfeeding after COVID-19 vaccination 3
• No serious side effects have been documented in mothers or infants across numerous large studies and registries 4

Benefits of Vaccination While Breastfeeding

Maternal vaccination provides dual protection for the infant through antibody transfer in breast milk. 2

• Breast milk from vaccinated mothers contains higher levels of influenza-specific immunoglobulin A (IgA) antibodies 1, 2
• COVID-19 vaccination results in SARS-CoV-2-specific functional antibodies and T cells in breast milk that benefit the infant's developing immune system 4
• Greater exclusivity of breastfeeding in the first 6 months decreases episodes of respiratory illness with fever in infants of vaccinated mothers 1, 2
• Breastfeeding activates innate antiviral mechanisms in infants, specifically type-1 interferons 2
• Infants born to mothers vaccinated against influenza have a 72% risk reduction for laboratory-confirmed influenza hospitalization in the first few months of life 2

Timing and Administration

Mothers should receive both vaccines as soon as they become available, ideally by the end of October for influenza vaccine. 2

• Influenza and COVID-19 vaccines may be administered simultaneously at different anatomic sites 2
• Women in the postpartum period who did not receive vaccination during pregnancy should receive influenza vaccine before discharge from the hospital 1
• There is no need to delay vaccination or pump and discard breast milk after receiving either vaccine 4

Common Side Effects

Maternal side effects are typically mild and do not require interruption of breastfeeding. 3

• The most common side effects include injection site pain, fatigue, myalgia, and headache 5
• Symptoms are more common after the second dose of COVID-19 vaccine 3
• Even among the small percentage of mothers reporting an adverse impact on breastfeeding, maternal confidence in their vaccination decision remained high 3

Critical Pitfalls to Avoid

Do not recommend separation of mother and infant or withholding breast milk after vaccination—these practices are not supported by evidence. 4

• Any recommendations to avoid vaccination while breastfeeding or to withhold breast milk for any period after vaccination are not evidence-based 4
• Live attenuated influenza vaccine (LAIV) is contraindicated during pregnancy but is safe during breastfeeding 2
• Continued breastfeeding should be encouraged even if the mother or infant has influenza illness 1