Vaccine / breastfeeding - any experts?

[namechange5575]

I'm a frontline NHS worker, likely to be offered the vaccine soon. I'm also (fairly casually) breastfeeding my 2.5 year old, mostly just at bedtime. You aren't supposed to have the vaccine if you are breastfeeding, but I can stop breastfeeding for a while - a few days, a week or so. Or at least I'd like to know how long I'd have to stop for, to inform a decision. Knowledge is power. Any knowledgeable experts around? Or where I can find the right person to ask? Thanks :)

Hopefully they will have more data soon because as it stands I won't be having it. But will wait and see...

Just to clarify- You couldn’t give her actual live coronavirus from the vaccine. The mRNA in the vaccine causes your cells to only make one small protein from the virus but not the whole live virus itself. So you become immune because your immune system can now recognise and target those proteins but you don’t get exposed to the live replicating virus at any point. During actual infection the mRNA the virus essentially puts into your cells makes all the different parts of the virus which then is assembled into the live virion/ replicating virus particle. mRNA getting through the mothers body into breast milk, then through a digestive tract remaining in tact seems very unlikely in my opinion. I’ve worked with RNA and usually, for example, if my sample is left at room temperature for a couple of hours accidentally then it starts to break down. It’s very fragile, much more so than DNA and humans are full are RNA degrading enzymes. I agree with other posters that’s hopefully we will have data showing this soon- but I would still have it if I could and I’m currently pregnant.

Will pregnant women receive the Covid-19 vaccine? It depends www.bbc.co.uk/news/world-us-canada-55340244

@namechange5575

Thank you everyone for replying, and especially *@Zippy1510* - that is exactly what I was looking for. (Haven't been able to look up all the links yet). So the only risk would be that my toddler could theoretically get coronavirus - not that it would permanently mess with their immune system in some way? Or some other developmental issue I'm not aware of? I think I'm coming down with it, and I've got a 4 and 7 year old who've both had exposure at school last week, so I'm not concerned about her getting it via me having a vaccine. I would feel safer for the clients I work with (over 65s service) if I could have it.

You want advice from experts? The expert advice is not to have the vaccination whilst breastfeeding. This is because the effects are not known. So f you want to take expert advice then don't have the vaccination until you have stopped breastfeeding completely.

In terms of the antibodies produced by the vaccine I can’t see any issues. They don’t tell you to stop breastfeeding whilst you have covid and you’d be making the same vaccine then.
So I guess there is a small chance the lipid nanopaerticles could get into the milk. Given they contain things like PEG which some people are allergic to I assume the risk is that if they got into the breast milk there is a minuscule chance they got prime an allergy to these compounds.
I don’t know how big this risk is and I guess Pfizer don’t either. I assume they must know how long they remain in the body for and how long in theory you might have to stop for.

Advice in the uk is not to have it. In USA I believe they say it’s safe.

It’s easy to say to wait to finish bf when 90% of the bf journeys last less than 6 months. However for those of us that bf for years it’s a crap advice.

@JS87

In terms of the antibodies produced by the vaccine I can’t see any issues. They don’t tell you to stop breastfeeding whilst you have covid and you’d be making the same vaccine then. So I guess there is a small chance the lipid nanopaerticles could get into the milk. Given they contain things like PEG which some people are allergic to I assume the risk is that if they got into the breast milk there is a minuscule chance they got prime an allergy to these compounds. I don’t know how big this risk is and I guess Pfizer don’t either. I assume they must know how long they remain in the body for and how long in theory you might have to stop for.

Pfizer do not know what the risk is or how big it is that's why the expert advice is not to have it whilst breastfeeding.

Of course there is nothing to stop anyone having the vaccine whilst breastfeeding but it is very clear that they would be doing something that is not advised by experts. They would be taking an unknown risk.

True. I should have said unknown risk rather than minuscule. I imagine in reality it is a small risk as only a small percentage of people are prone to allergies but you are right that we don’t know.

PEG is also found in lots of food products so presumably the risk might also be different for a newborn drinking only milk versus a 2.5 year old who is also eating food. A bit like the debate around when to first give nuts etc.

So there is some concern about allergies to PEG in everyone. It is already found in a large range of medications and cosmetic products, it’s considered relatively inert and reactions are extremely rare- but the risk remains. Pregnant and nursing healthcare workers in the US are able to get vaccinated. We are waiting for more evidence on limited reactions to approve it. However if I had the choice I would take it. With the new strain showing higher levels of infectivity due to higher binding affinity and us not knowing what this will mean with regards to children (who have traditionally been at lower risk partially due to lower numbers of receptors meaning less binding) I would prefer to expose my child to PEG than VUI202012/01 if I had the choice.

Also feeling frustrated by this. People at work started getting it last week, I really want it too (to keep the vulnerable people I work with safe, but also because I have two clinically vulnerable close family members). I’m breastfeeding my 18month old a million times a day, don’t want to wean yet and I fed my older children til over 2.
A nurse friend is having the Pfizer vaccine in the next couple of weeks although she’s still feeding her toddler. I’m so sure it’d be safe but I just don’t quite think I can bring myself to go against official advice.
I think I’ve read somewhere that the Oxford vaccine might be more likely to be suitable while breastfeeding? Don’t know if there’s any truth in that though.

@lemonjam

Also feeling frustrated by this. People at work started getting it last week, I really want it too (to keep the vulnerable people I work with safe, but also because I have two clinically vulnerable close family members). I’m breastfeeding my 18month old a million times a day, don’t want to wean yet and I fed my older children til over 2. A nurse friend is having the Pfizer vaccine in the next couple of weeks although she’s still feeding her toddler. I’m so sure it’d be safe but I just don’t quite think I can bring myself to go against official advice. I think I’ve read somewhere that the Oxford vaccine might be more likely to be suitable while breastfeeding? Don’t know if there’s any truth in that though.

If your nurse friend had admitted she was breastfeeding then she would not have been vaccinated. You could only get vaccinated whilst breastfeeding if you don't admit to it. No health professional would go against expert advice and vaccinate a breastfeeding mother.

Well the Oxford vaccine doesn’t have lipid nanoparticles. Not sure what it is packaged in but I guess it’s more inert. Hopefully that one will be approved for breastfeeding. There must be a large number of frontline workings who could be ttc, pregnant or breastfeeding for the next few years.

Billie18 No she won’t have told them/they won’t have asked - I find when your baby is over 1 people assume they’re no longer breastfeeding unless told otherwise. Not saying it’s the right thing to do, just she was surprised I was even worried about it.

Contact the Breastfeeding Network on Facebook via direct message, they can put you in touch with a proper pharmacist who specialises in breastfeeding - as far as I know this is the only way to access such expertise, which is nuts isn't it?

Most other pharmacists will just say "don't do it" once they reach the end of their specific knowledge on breastfeeding which is usually about zero.

@lemonjam

Billie18 No she won’t have told them/they won’t have asked - I find when your baby is over 1 people assume they’re no longer breastfeeding unless told otherwise. Not saying it’s the right thing to do, just she was surprised I was even worried about it.

Before anyone has the vaccine they have to sign a consent form. On the consent form there is a box that all women of child bearing age have to tick to say they have read the leaflet on pregnancy and breastfeeding. This leaflet is clear that women who are breast feeding should not have the vaccine. So your friend either ticked the box to say she had read the leaflet when she hadn't or decided to get vaccinated against expert advice.

Just looked at the other thread on this topic (linked to early on) and someone has posted the following link which is a really interesting discussion of the choices breastfeeding HCPs currently facing

blogs.bmj.com/bmj/2020/12/21/healthcare-workers-who-breastfeed-should-be-offered-the-covid-19-vaccine/

"Pfizer do not know what the risk is or how big it is that's why the expert advice is not to have it whilst breastfeeding. "

It depends which expert's doesn't it? The cdc have said it's parent's choice, as have other countries regulators. I have seen plenty of microbiologists/ virologists saying it is incredibly unlikely to be unsafe. The Pfizer vaccine not only contains no live virus, it's about making one specific protein. Any of this protein in your milk will just get digested like any other proteins.

I won't be having this one but awaiting advice re the Oxford one... I'm a primary teacher on mat leave (baby coming up for seven months). I will be extended breastfeeding.

Stop breastfeeding and have the vaccine. There's no data yet to say what's safe regarding breastfeeding so, don't take a risk.

@Sertchgi123 Not a chance. Breast is best. For both mother and baby. Fact. I won't be stopping.

I won’t be stopping feeding until baby wants to. He’s only 7 months and it’s still his main source of food. With Covid, surely it’s best for his immune system he is breastfed as long as possible

They also say not to take if your looking to conceive within 3 months. By the time ds is 18 -24 months, we might be considering a second child, so I’m not sure when would be a good time

The Pfizer vaccine has now been approved for breastfeeding mothers in the US, Ireland and most of the EU. Hopefully the advice will change here soon but until then, it's crazy for anyone to advise stopping breastfeeding just to get vaccinated. It would probably be safer just to lie tbh.

@Sertchgi123

Stop breastfeeding and have the vaccine. There's no data yet to say what's safe regarding breastfeeding so, don't take a risk.

This is terrible advice! We do actually have a ton of data about what's safe in breastfeeding but so many people (medics included) choose to ignore it in favour of scaring mothers into giving up.

@Caspianberg Totally agree. My baby is coming up for seven months too and I'll be bf'ing until she self-weans (around 3 if my other two were anything to go by).

I don't have your ttc worries as I'm 40 already and she's my last baby, but I can see your quandry with this too. If you have finished bf'ing at that point, could you possibly hold off ttc for a bit to have the vaccine? Just thinking out loud...