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ACOG Recommends COVID Vaccine While Pregnant or Breastfeeding

Mom breastfeeds newborn baby

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Key Takeaways

  • The COVID-19 vaccine trials haven't included pregnant and breastfeeding people, so we don't know for sure that the vaccine is safe for those individuals.
  • However, experts from the American College of Obstetricians and Gynecologists (ACOG) believe that any theoretical concerns regarding the safety of the shot for breastfeeding people don't outweigh the potential benefits of the vaccine.
  • The Centers for Disease Control and Prevention (CDC) announced that someone who is breastfeeding when they are offered the vaccine can decide whether to have it or not.

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 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 the Centers for Disease Control and Prevention (CDC) stated on December 15, 2020, that the decision was one for each individual to make. 

American College of Obstetricians and Gynecologists

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.

— American College of Obstetricians and Gynecologists

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 making a decision based on very limited information. But some reassurance may come from a practice advisory issued on December 13, 2020, by the American College of Obstetricians and Gynecologists (ACOG). It 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.

Leigh Anne O'Connor, IBCLC, LCCE

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.

— Leigh Anne O'Connor, IBCLC, LCCE

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 Parents 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 people will put additional pressure on them at a time when they’re already 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.”

Sherry Ross, MD

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.

— Sherry Ross, MD

It’s new territory, 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.”

What This Means For You

Unless you’re a health care worker, it may be a long while before you’re actually offered the COVID-19 vaccine. But if you do fall into a priority group and you're pregnant or breastfeeding, it may be in your best interest to get the vaccine. The choice is yours—but discuss it with your healthcare provider, who can hopefully help to clarify the situation and alleviate any concerns you may have.

The information in this article is current as of the date listed, which means newer
information may be available when you read this. For the most recent updates on
COVID-19, visit our coronavirus news page.

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  1. Centers for Disease Control and Prevention. Vaccination considerations for people who are pregnant or breastfeeding. Updated January 7, 2021.

  2. American College of Obstetricians and Gynecologists. Vaccinating pregnant and lactating patients against COVID-19. Updated December 21, 2020.