ACOG Recommends COVID Vaccine While Pregnant or Breastfeeding

Pregnant and lactating people were excluded from the early clinical trials of the COVID-19 vaccines, including the Pfizer/BioNTech and Moderna vaccines that have recently been granted emergency use authorization by the Food & Drug Administration (FDA).

This initially led to concerns that pregnant and breastfeeding individuals wouldn’t be offered the shot. But after several days of widespread speculation, the Centers for Disease Control and Prevention (CDC) stated on December 15 that the decision was one for each individual to make. 

Can the COVID-19 Vaccine Harm a Breastfed Baby?

Although there is no data on the safety of COVID-19 vaccines in lactating women, or on the effect of mRNA vaccines on the breastfed infant or on milk production, the CDC states that “mRNA vaccines are not thought to be a risk to the breastfeeding infant.” As such, people who are breastfeeding and part of a group recommended to get the vaccine, like health care workers, may choose to get vaccinated.

This means a breastfeeding healthcare worker has to make a decision based on very limited information.

But some reassurance may come from a new practice advisory, issued on December 13 by the American College of Obstetricians and Gynecologists (ACOG), which states that the mRNA vaccines are not live virus vaccines, and don’t use an adjuvant to enhance vaccine efficacy. This means they don’t enter the nucleus, or alter human DNA in the vaccine recipient. As such, they can’t cause any genetic changes.

The ACOG believes that “COVID-19 vaccines should be offered to lactating individuals similar to non-lactating individuals when they meet criteria for receipt of the vaccine based on prioritization groups outlined by the ACIP [Advisory Committee on Immunization Practices].” In other words, they’re on the same page as the CDC—it’s up to the individual whether they get the vaccine or not.

Obviously, there are still unknowns regarding the vaccine during pregnancy and in lactating people. But the ACOG says “theoretical concerns regarding the safety of vaccinating lactating individuals do not outweigh the potential benefits of receiving the vaccine.” The organization adds that there is no need to avoid starting or continuing with breastfeeding if you get the vaccine.

New Moms Don’t Need More Pressure 

International board certified lactation consultant Leigh Anne O’Connor, IBCLC, LCCE, says she’s concerned that the lack of data about the safety of the vaccine in breastfeeding moms will put additional pressure on them at a time when they’re already typically physically and mentally exhausted.

But O’Connor believes that from the data that’s available, the benefits outweigh the risks. “Little or none of the components of the vaccine will pass into the baby through the mom's milk,” she says. “Plus, there is the suggestion that the baby will gain additional immunity from the breastfeeding parent. Parents have to make an informed decision—they have to know if they are at risk for having complications from a vaccine or have risks that make having COVID-19 more serious for them.”

It’s new territory, then, and it’s important to talk through your decision with your midwife, OB/GYN, pediatrician, or family doctor to rule out any risk factors. “If there are no other risks, then the vaccine is likely safe,” O’Connor says.

Sherry Ross, MD, OB/GYN and women’s health expert at Providence Saint John’s Health Center in Santa Monica, California, agrees. “The new COVID-19 vaccine has brought some much-needed light amidst the darkness of the pandemic,” she says. “Even though there is no scientific data available on the safety and effectiveness of the COVID-19 vaccine in pregnant and breastfeeding women, the OB/GYN experts at the ACOG are making some calculated guidelines for this high risk group.”