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My breastfeeding friend is concerned about getting vaccinated; what are your thoughts?

Question: A friend of mine is currently breastfeeding and doesn’t want to get the vaccine. I get it and remember feeling so worried about anything I put in my body when I was breastfeeding. She also had COVID during pregnancy and was able to recover completely. Given this, she’s not eager to get vaccinated anytime soon. I understand her vaccine hesitancy, but I also see her vulnerability as family and friends want to visit her and meet the new baby. What are your thoughts?

Answer: It sounds like you’re coming from a place of understanding and concern, which is a good starting point for any difficult conversation.  And a conversation with a new mom about her choices is most certainly a difficult conversation!  For some tips, see Q&A of 4/9/21 and Q&A of 2/2/21 (think: empathetic conversations built on open-ended questions and listening).  Even if she continues to choose to forgo the vaccine right now, you can talk with her about other ways she’s keeping herself and her newborn safe– like only allowing fully vaccinated people to visit with her and the baby.  Here are a few nuggets that may be helpful:

  • Safety and effectiveness: Even though pregnant and lactating women were not included in clinical trials, evidence is growing that the Pfizer and Moderna vaccines are safe and effective for pregnant and lactating women and their babies (see CDC’s Information for People who are Pregnant of Breastfeeding, recent American Journal of Obstetrics and Gynecology published research, and recent NEJM published research).
  • Immune protection for babies: Antibodies produced through vaccination are much more abundant in breastmilk than antibodies produced through infection (see Q&A of 5/6/21); this means vaccinated mom’s breast milk is more likely* to confer immune protection to babies [*note: this inference is still not proven, but it is plausible].
  • Protection against variants: Evidence is growing that Pfizer (and likely Moderna) protects against other variants of concern, namely B.1.1.7 and  B.1.351 first discovered in the UK and South Africa, respectively.  Findings out of Qatar, published last week in New England Journal of Medicine, and described in a Nature news report indicate that Pfizer vaccination confers high degree of protection against infection against variants of concern and provides very high (97%) protection against severe disease outcomes caused by variants of concern.  This is likely* higher protection than conferred by natural immunity from previous infection (see NEJM article here) [*again, this supposition is not yet proven, but seems increasingly likely]