From the Guidelines
Breastfeeding is not a contraindication for any vaccine, with the exception of smallpox vaccine. According to the Advisory Committee on Immunization Practices (ACIP) recommendations [ 1 ], neither inactivated nor live vaccines administered to a lactating woman affect the safety of breastfeeding for women or their infants.
Key Points
- Inactivated vaccines are safe during breastfeeding [ 1 ]
- Live vaccines are also considered safe while breastfeeding, with the exception of smallpox vaccine [ 1 ]
- Breastfeeding women can receive all routinely recommended vaccines, including influenza, Tdap, and COVID-19 vaccines
- The safety of vaccines during breastfeeding stems from the fact that most vaccine components cannot pass into breast milk, and for live vaccines, the weakened viruses are unlikely to cause infection in the infant through breast milk [ 1 ]
Vaccine Safety
The ACIP recommendations [ 1 ] indicate that breastfeeding does not adversely affect immunization and is not a contraindication for any vaccine, except for smallpox vaccine.
Recommendations
- Breastfeeding women should receive all routinely recommended vaccines, including influenza, Tdap, and COVID-19 vaccines
- Live vaccines, such as MMR (measles, mumps, rubella), varicella, and zoster, are considered safe while breastfeeding [ 1 ]
- Smallpox vaccine should be avoided during breastfeeding due to potential transmission risks [ 1 ]
From the Research
Vaccines Contraindicated While Breastfeeding
- There are no specific vaccines contraindicated while breastfeeding, as most vaccines are considered safe for use during lactation 2, 3.
- Live and/or live-attenuated virus vaccines are generally contraindicated during pregnancy, but this does not apply to breastfeeding women 2, 4.
- Inactivated viral vaccines, bacterial vaccines, and toxoids are considered safe for use during breastfeeding 2, 4.
- The Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists recommend that lactating individuals receive COVID-19 mRNA vaccines and stay up to date on booster doses, including the bivalent COVID-19 booster 3.
Safety of Vaccines During Breastfeeding
- Numerous studies have demonstrated the safety and efficacy of COVID-19 vaccines during lactation, with no serious side effects reported in mothers or infants 3.
- Breast milk from vaccinated individuals contains severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific functional antibodies and T cells, which benefit the breastfeeding infant's developing immune system 3.
- There is no evidence to suggest that vaccine mRNA can survive the infant gastrointestinal tract or cause harm to breastfeeding infants 3.
Benefits of Breastfeeding and Vaccination
- Breastfeeding can help improve response to vaccines in infants and influence physiologic parameters that can change metabolism of ethylmercury derived from some vaccines 5.
- Exclusive breastfeeding up until 6 months can provide maximum protection for infants and complement vaccination, with a possible beneficial effect on the vaccine response 5.