Is maternal vaccination safe during breastfeeding?

Use of vaccines during breastfeeding is common and is a debatable issue. Theoretically, high titers of immunoglobulins in breast milk might reduce the efficacy of the same vaccine administered to infants.

However, there is no evidence or reason to believe that inactivated or recombinant vaccines would harm a nursing infant. Live attenuated vaccines given to the mother could conceivably infect the infant, but most live vaccines do not pass into milk or harm the infant. Two exceptions are yellow fever and smallpox vaccines, which can infect infants and should be avoided in nursing mothers.

In light of the continuing anti-vaccination movement, a provocative new article provides a comprehensive overview of the potential risks of vaccinating breastfeeding women. The article, which determined that only smallpox vaccine and, in some circumstances yellow fever vaccine, are the only vaccines having the potential to cause harm to infants, is published in Breastfeeding Medicine, the official journal of the Academy of Breastfeeding Medicine published by Mary Ann Liebert, Inc., publishers. Click here to read the full-text article free on the Breastfeeding Medicine website through May 10, 2019.

In "Maternal Vaccination and Breastfeeding," Philip Anderson, PharmD, University of California San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, reviewed all of the most common types of vaccines, including inactivated and live attenuated types for the unsubstantiated concern that they would cause harm to a nursing infant or interfere with the infant's response to early childhood vaccinations. Included in the scope of Dr. Anderson's review are routine vaccines such as influenza, diphtheria, pertussis and tetanus (DPT), varicella and measles, mumps, and rubella (MMR). The article also focuses on vaccines related to exposure or special risk factors, such as hepatitis A or hepatitis B, and specialty vaccines including cholera, yellow fever, smallpox, rabies, and typhoid.

"As Dr. Anderson concludes in his timely and important article, there are no risks associated with giving breastfeeding mothers routine and most other standard vaccinations, including measles, and, in fact, there are benefits for both the mothers and infants," says Arthur I. Eidelman, MD, Editor-in-Chief of Breastfeeding Medicine. These benefits include the transfer to the infant of maternal antibodies and an enhanced antibody response and less vaccine-related fever following infant vaccination, as Dr. Eidelman explains in the accompanying editorial entitled "Guidelines for Vaccinating Breastfeeding Mothers."

Dr. Eidelman further notes that "not only is there no harm in administering routine vaccinations to breastfeeding mothers, but one can and should include nursing mothers in any emergency measles immunization campaign, such as the recent emergency declared by the New York City Health Department."

For more details click on the link: http://dx.doi.org/10.1089/bfm.2019.0045