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The New York Times

Vaccinated mothers try to give antibodies to babies through breast milk

As soon as Courtney Lynn Koltes returned home from her first date for the COVID-19 vaccine, she pulled out a breast pump. She had stopped breastfeeding her daughter about two months earlier due to a conflicting medication. But she no longer had those pills and had recently come across research suggesting that antibodies from a vaccinated mother could be passed to her baby through milk. Flowing the milk again – a process known as relactation – wouldn’t be easy. She planned to pump every odd hour from 7 a.m. to 11 p.m. But Koltes and her husband were eager to finally introduce their 4 month old daughter to family members, and with the children not yet eligible for vaccination, she was ready. to do it. try. “I’m starting to see very slow progress so it’s worth it if it means I can protect her,” said Koltes, who lives in Orange County, Calif., Last week – nine days after receiving her first dose of Pfizer. BioNTech vaccine. Sign up for The Morning New York Times newsletter Partly because it is so physically demanding, relactation is not common. (Medication is often involved as well.) But in recent weeks, relactation-focused online forums have been swarmed with newly vaccinated mothers like Koltes. Some had stopped breastfeeding their children more than a year ago. “I’m glad I’m not the only one here trying to raise for this reason!” a woman wrote in an animated thread in a private Facebook group. “Go get the vaccine as a team!” another wrote. In stark contrast, other parenting and breastfeeding forums have simmered with fears that breast milk from a newly vaccinated mother could be dangerous. It was not only vaccine skeptics who encouraged these fears, which researchers believe are unfounded; some pediatricians and vaccine administrators have urged nursing mothers to empty their milk after being vaccinated. So what is it? Is breast milk from a vaccinated person some kind of elixir that can ward off COVID? And if so, do newly vaccinated mothers introduce breast milk into cereal for older children or do they share their extra milk with friends’ babies on something? Or should breastfeeding mothers refrain from getting vaccinated? The answer, six researchers agreed, is that newly vaccinated mothers are right to feel like they have a new superpower. Multiple studies show that their antibodies generated after vaccination can actually pass through breast milk. As with so much to do with the coronavirus, further research would be beneficial. But there is no concrete reason for new mothers not to be vaccinated or to empty their breast milk, they said. Does “vaccinated breast milk” contain antibodies? Yes, study after study shows that it contains antibodies. It is not yet clear how exactly these antibodies protect the infant against COVID. In the first nine months of the pandemic, around 116 million babies were born worldwide, according to UNICEF estimates. This left researchers scrambling to answer a crucial question: Could the virus be transmitted through breast milk? Some people assumed it was possible. But as several groups of researchers tested the milk, they found no trace of viruses, only antibodies – suggesting that drinking milk could protect babies from infection. The next big question for breast milk researchers was whether the protective benefits of a COVID vaccine could be passed on to babies in the same way. None of the vaccine trials included pregnant or breastfeeding women, so researchers had to find qualified breastfeeding women for the first deployment of the vaccine. Through a Facebook group, Rebecca Powell, breastmilk immunologist at Icahn School of Medicine in Mount Sinai in Manhattan, found hundreds of doctors and nurses willing to share their breastmilk periodically. In her most recent study, which has not been officially published, she analyzed the milk of six women who received the Pfizer-BioNTech vaccine and four who received the Moderna vaccine, 14 days after the women received their vaccine. second injection. She found a significant number of a particular antibody, called IgG, in each of them. Other researchers have had similar results. “There is reason to be excited,” said Dr. Kathryn Gray, a maternal fetal medicine specialist at Brigham and Women’s Hospital in Boston, who has conducted similar studies. “We’ll assume that might provide some level of protection.” But how do we know for sure? One way to test for this – to expose these babies to the virus – is, of course, unethical. Instead, some researchers have attempted to answer the question by studying the properties of antibodies. Are they neutralizing, that is, they prevent the virus from infecting human cells? In a draft of a small study, an Israeli researcher found that they were. “Breast milk has the ability to prevent viral spread and block the ability of the virus to infect host cells that will lead to disease,” Yariv Wine, an applied immunologist at Tel Aviv University, wrote in an email. . However, the research is too premature for vaccinated breastfeeding mothers to act as if their babies cannot be infected, said Dr Kirsi Jarvinen-Seppo, chief of the pediatric allergy and immunology department at the medical center of the ‘University of Rochester. Jarvinen-Seppo carried out similar studies. “There is no direct evidence that COVID antibodies in breast milk protect the infant – only evidence to suggest that this could be the case,” she said. How long could the protection last? As long as the baby is consuming breast milk that contains antibodies. The Destiny Burgess twins were born prematurely. Burgess and her husband are back at work in Asheville, North Carolina. One of their older children is in kindergarten. Two are in daycare. All of this worries Burgess for her 3-month-old babies. When a vaccinated friend offered to share some of her milk with the twins, she agreed. “I feel like I have this new superpower,” said friend Olivia de Soria. In addition to feeding her own 4-month-old daughter and adding some of her milk to her 3-year-old’s chocolate milk, de Soria now shares her milk with five other families. “They can’t get the photo, so it gives me a little bit of peace of mind,” Burgess said. However, she wonders how much “vaccinated milk” would be needed to make a dent. The unsatisfactory answer is that it is not clear. What researchers agree is that a baby who consumes breast milk all day is more likely to be protected than one who receives only an occasional drop. But no one scoffed at the idea of ​​giving older kids a bit if that wasn’t a problem. They also agree that the protective benefits of breast milk work more like a pill you have to take every day than an injection that lasts for a decade. This short-term defense – known as “passive protection” – can only last for hours or days from the baby’s last “dose”, Powell said. “It’s not the same as the baby gets vaccinated,” she added. That means “as soon as you stop feeding that breast milk, there is no protection – period,” said Antti Seppo, another breast milk researcher at the University of Rochester Medical Center. Seppo also found that it took about two weeks after the first injection for the antibodies to appear in the milk and peak after the second injection. How do we know that “vaccinated breast milk” is safe? Researchers say they know enough about how vaccines typically affect breast milk not to be concerned. Several researchers involved in breast milk and COVID vaccine research have offered slight variations of the same opinion. “There is no reason to believe that there is anything in this vaccine that would make it harmful, and there is reason to believe that it would be beneficial,” said Christina Chambers, co-director of the Center. for Better Beginnings at the University of California. , San Diego. So why are parenting forums full of stories about pediatricians telling mothers to wait to get vaccinated until their babies are older or to empty their milk after vaccination? Mainly because breastfeeding mothers were not included in vaccine trials, researchers were therefore unable to concretely study the risks. But researchers’ confidence that breast milk from mothers vaccinated against COVID-19 is safe stems from what is widely known about how vaccines work. “Unlike pregnancy, where there are theoretical safety issues, there really aren’t any lactation and vaccination issues,” Gray said. Moderna and Pfizer-BioNTech products are mRNA vaccines. “The ingredients in the vaccine are mRNA molecules that have a short lifespan and have no way of making their way into the milk,” Seppo said. Is relactation really worth all the effort? Maybe not, decides an initially enthusiastic mother. Almost two weeks later, Koltes was only able to pump a few drops of breast milk at each session. An email exchange with her pediatrician confirmed that she couldn’t be sure – even if she was pouring milk – that allowing unmasked and unvaccinated parents to hold her daughter was safe. She applauded other women having more success with relactation. But for her, that was it. “It feels like a weight is being lifted,” she said of dropping her rigorous pumping schedule. All that remains is to wait for a real vaccine for her daughter, she said. Pfizer and Moderna recently started testing their vaccines on babies as young as 6 months old. This article originally appeared in The New York Times. © 2021 The New York Times Company



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