Covid antibodies: breastfeeding edition

February 10, 2021 3:31 AM

I am still breastfeeding my 7 month old but have been feeling kinda done with it for a while. I am constantly worried about my supply and taking supplements for it. I am still waking up to do night feedings so I am tired during the day but need to restrict my caffeine intake so he doesn't get all hyped up. But I have been waiting for the covid vaccine...

and have no idea when I will be able to get it. I am in my 30s with no health issues so I am pretty much all the way down the list. I have been plowing ahead with breastfeeding in hopes that when I get the vaccine, I will be able to confer some immunity to my baby. But... will it actually work that way? I know antibodies are definitely passed through breastmilk, but will they actually protect my baby? On the one hand, I'm feeling ready to kind of be "untethered" from my baby but I just feel guilty stopping if I could give him something that would benefit him and didn't do my best to achieve it. I have been waffling back and forth on this and would love to get some opinions.

posted by Forty-eight to Health & Fitness (20 answers total)

We do not know this conclusively yet. No breastfeeding people were in the vaccine trials, as far as I'm aware, so it will be a while until any evidence is available.
posted by knapah at 3:57 AM on February 10, 2021 [2 favorites]

First of all, fed is best, obviously.
Second of all, every drop of breast milk has had a positive impact so far.
Thirdly, it's important to make choices so that you are the best parent you can be- if you need to wean, to do that, then it's a valid choice!

The recommendation is that infants 1 year and under should be getting their primary nutrition from milk, whether breast or formula. Also, the WHO recommends breast feeding for the first 2 years of life.

As to immunity and covid in particular, I don't think there has been a lot of research. Definitely it provides an immune boost. But you don't have to exclusively breast feed for this benefit.

At 7 months you could try night weaning, and just breast feed during the day. This of course might affect your supply, but then again being better rested may help you with your supply!

I've found r/breastfeeding (Reddit) helpful with my breast feeding journey.
posted by freethefeet at 4:00 AM on February 10, 2021 [2 favorites]

This internet stranger gives you permission to put on your own oxygen mask first. Which decision is best for you right now, especially considering we don't have all the information right now and life during a pandemic is difficult? This isn't a purely selfish decision, since baby will also benefit from a less stressed out parent.
posted by oceano at 4:10 AM on February 10, 2021 [20 favorites]

Although some young children have got very sick from covid, the numbers are exceptionally low. Unlike the flu, it doesn't seem to affect babies very badly, which I suppose is one small mercy. You should absolutely take all the usual precautions to protect your child - low risk is not zero risk, and they can still pass covid on - but if they're otherwise healthy, I don't think it is worth it for you to delay weaning if it's something you need for your own wellbeing.
posted by Acheman at 4:30 AM on February 10, 2021 [5 favorites]

Fed is best, as others have said. And we really don't know about COVID/vaccines and breast-feeding, so I would not recommend putting any emphasis on that.

Caveat - I don't have kids/have not ever breast fed, but I have turned up and given my brother's kids bottles in the night when their parents were just SO tired, and that worked out ok. I have a bit of a thing about the super pressure to breast feed above all else, so perhaps I'm biased...but again, i don't have kids or breast feed.

It's hard to know what's best to do in weird times, and information changes very fast, but please don't feel guilty about whatever you do. So far, there is no evidence at all about vaccine to milk, so I wouldn't worry that by not breast feeding you are missing out on that. good luck with whatever you decide.
posted by sedimentary_deer at 4:49 AM on February 10, 2021

In Europe, the Pfizer vaccine at least is not recommended for breastfeeding women for lack of testing. AFAIK all vaccines approved so far haven't been tested on under-18s.
posted by I claim sanctuary at 5:00 AM on February 10, 2021

I am about 5 months ahead of you. I intended to breastfeed until 6 months but continued until 10 months because of covid.

From what I understand (I am definitely not a doctor or immunologist), the passive immunity a baby gets from breastmilk (for other diseases; there is no covid data yet) does not last long once breastfeeding stops, only up to a couple of months. So you aren't asking whether you should keep breastfeeding until you get vaccinated, the question is whether to keep breastfeeding until baby is vaccinated.

Little kids probably won't be able to get the vaccine for a whole year--they have just started trials for the 12-16 range, and then they work down from there. Do you want to keep going for another year?

I didn't. I felt so guilty and scared when I decided to stop. But for me it was absolutely the right decision. The best thing I can do is prevent my kid from getting covid in the first place, which has been successful so far. And it is such a relief to finally have my body back after a year and a half (and wear normal bras again!) and not have the weight of feeling 1000% responsible for my kid's health. And kiddo is healthy and happy and everything is okay so far.

Good luck. :)
posted by jessica fletcher did it at 5:09 AM on February 10, 2021 [11 favorites]

We don't know yet is really the answer.

You've done a great job, and holding out just in case your breastmilk carries enough antibodies, *and* they convey some immunity, *and* it's enough to protect your baby in a given situation where your baby is exposed...is really a long chain of ifs, out of the 1,000 things you do every day to care for your child.

It's really okay to be done.
posted by warriorqueen at 5:11 AM on February 10, 2021 [10 favorites]

I personally much preferred breastfeeding when I stopped worrying about supply and went down to a frequency that was comfortable for me (meaning more formula supplementation). At this point, your baby is starting solids too which should take some pressure off, and as long as you’re doing 3x a day or so, you’re unlikely to trigger full on weaning. I’m still nursing at 20 months, but there’s very little coming out and I don’t care.

That is to say, it’s not all or nothing, and you can have the best of both worlds by taking it easy. It’s also fine to stop.
posted by redlines at 5:22 AM on February 10, 2021 [3 favorites]

I totally understand that COVID is very much in the news all the time and it is front of mind. However, it really truly is mainly a danger to people who are much older or who have other comorbidities. Low risk is not no risk, but for example, your baby's risk of getting hospitalized for RSV in a given year are higher than its chance of having been hospitalized for COVID in the past year:

Let’s look first at COVID-19 itself. For a child between the ages of 1 and 17, the risk of death from COVID-19 is about 1 in 700,000 over this last year. The hospitalization risk is in the range of 1 in 50,000. For children under 1, the risks are slightly higher. A bit more context on this is below, but these numbers are still really small. COVID-19 accounts for only 0.2% of deaths among children under 1 year.

Numbers in this range are so small it can be hard to think about what they mean. Which is why comparisons are useful. The second two sets of columns look at two other sources of illness and death : RSV (respiratory syncytial virus, a common childhood respiratory virus) and drowning. For children under 1, the death rate from RSV in a typical year is three times higher than the death risk from COVID. The hospitalization rate is about 200 times as high. Put simply: in a typical year a child under 1 is 200 times as likely to be hospitalized for RSV than they were for COVID last year. It accounts for an extremely tiny portion of all deaths to infants in the last year.

These numbers are not fun to think about but they have to be grappled with if you're thinking about decisions for your family. I understand where you're coming from, I truly do - I have a 3 year old and a 6 month old and I feel the fiercest need to protect them. But based on the above, I would just do what you would normally do. It doesn't seem to me that COVID really needs to be a factor when you're making decisions about whether to stop breastfeeding or not.
posted by peacheater at 6:48 AM on February 10, 2021 [3 favorites]

This study was just released yesterday to reporting that breastfeeding mothers with COVID-19 do pass antibodies in their milk that can neutralize the virus. Doesn’t mean that vaccination will have the same result though.
posted by HotToddy at 8:43 AM on February 10, 2021 [2 favorites]

UNC has the phenomenal Carolina Breastfeeding Institute and lots of fantastic research around breastfeeding and implications for parent and child alike. I would look at this page to stay up to date on research and use that to inform your choices.

One the of the main prerequisites for breastfeeding, emergency situation or not, is that it is desired by both child and the person giving or expressing milk. It seems like you may be coming up on a time where that is no longer true.
posted by raccoon409 at 8:50 AM on February 10, 2021 [2 favorites]

I am a huge proponent of nursing, but you sound so, so tired. Are you giving your baby additional food? It's okay to give supplemental formula or other foods; you've done the critical part, and you deserve a break. I nursed for 18 months, the last several months were mostly comfort feeding at night with my colicky baby. Try to decide how to adjust breastfeeding, food, and your schedule to get more rest. Your baby is at low risk from Covid; your risk goes up if you're really run down.

I don't think anyone can accurately answer the question of Covid vaccination, antibodies, breast milk and babies. Even in this massive vax rollout, there are many, many questions unanswered. It's a frustrating and scary time for anybody who takes Covid seriously, as they should. Take care of yourself so you can stay healthy, take care of your baby. Maybe try to breastfeed some for as long as possible, but not necessarily full time.

After I stopped nursing my baby, I missed some things about it, so, if you can, prioritize making it cozy, loving, comfortable. Good book or streaming video, or good music, and relaxing in a comfy chair or bed. Max out whatever endorphins and oxytocin while it's available. Not to the extent that it's exhausting.
posted by theora55 at 8:53 AM on February 10, 2021 [1 favorite]

The benefits of breastfeeding for providing immunity are actually, all things considered, relatively small (though they are there). The results may serve as a proxy for a lot of other factors such as investment in a baby's health and welfare, income, parental privilege, etc. Here's a thoughtful article: https://qz.com/1403011/why-is-breastfeeding-science-so-controversial/

It's good for the baby. But you may be providing a fraction of a percentage of improvement. It's up to you, as everyone has said.

(Emphasizing that I loved breastfeeding my kid, and my kid in turn experienced great difficulty with it because the grandchild was premature, and they found my information about the research very reassuring.)
posted by Peach at 8:59 AM on February 10, 2021

Everything I'm about to say has been said, but in case you need to hear it again:

You are doing a great job.

You can combo formula and breastfeed, and you will be doing a great job.

You will still be doing a great job if you stop breastfeeding. You may even end up doing a better job because it will give you more emotional bandwidth to be a better parent in other ways. You say "I just feel guilty stopping if I could give him something that would benefit him and didn't do my best to achieve it." What if breastfeeding is the thing getting in the way of giving him some other benefit?

Reducing COVID risk is not the be-all-end-all of "being healthy" even if it feels like that right now.
posted by natabat at 9:01 AM on February 10, 2021 [3 favorites]

Breastfeeding is much easier to handle once you quit getting up at night to do it.

I think you don't need to decide on whether or when to wean right now, just about the night feedings. I did night-weaning at six months and we still had the immunological benefits from the remaining feedings (if I caught a cold at work, I didn't pass it on to the baby because of the antibodies getting there first; he still caught a cold when he got exposed to it first though, since then I didn't yet have antibodies to pass on).

Weaning is best done by cutting out one feeding per day at a time, anyway. It's much easier on your breasts than stopping all at once. So cut out the night feeding first, then go on from there. Any decision you make is right, but the gradual process makes it all so much easier.

I noticed I started feeling a whole lot better a week after I started sleeping through the night all night. Those night feedings really took it out of me. It took a week to catch up enough to feel like myself.
posted by chromium at 10:15 AM on February 10, 2021 [2 favorites]

Specifically addressing immunity & COVID:

First, We don't know. It's hard, but we don't know if breastmilk can introduce effective COVID antibodies to babies. Breastmilk does contain certain antibodies for other viruses but evidence on whether this is actually effective is mixed. There are a lot of confounding factors, such as the fact that formula fed babies are way more likely to be in daycare and exposed to more viruses.

Second, it is entirely possible that by the time a vaccine is available to you, it will be available to your kid as well. Companies are currently testing the vaccine on children as young as 12, and experts are predicting that the vaccine will be approved for all ages by late 2021.

My baby is a little bit older than yours (she is 13 months) and I have gradually started to wean for my mental health, I am not waiting for the vaccine. There are too many uncertainties and I am already doing my best to protect her by socially distancing and wearing a mask (or two, now). But I have found that reducing feeds goes a long way for me personally and I may be able to nurse her one or two times a day for many months.
posted by muddgirl at 12:24 PM on February 10, 2021

Is there a reason you are worried about your supply? I feel like supply concerns are so incredibly common because there's not enough accurate breastfeeding support out there, but rarely are these concerns founded.

It's very possible that you don't need to stress yourself out and take supplements. Everything that I've read suggests that supplements are not helpful anyway, the only way to maintain supply is effective removal of milk from the breast.

You don't have to keep exclusively breastfeeding if you don't want to. It's my personal preference to breastfeed my eight month old, but it's not for everyone.

Could you consider combi feeding? Swap some feeds to formula (slowly, one feed at a time) and feed directly from the breast the rest of the time? That could be a good compromise.
posted by kinddieserzeit at 11:18 PM on February 10, 2021 [1 favorite]

Of course it's okay to stop if you need to. Fed is fed and your baby needs you mentally healthy.

That said, barring health concerns you haven't mentioned this child is almost certainly physically ready to sleep through the night. You seem kind of back and forth on nursing, if that's true maybe consider first working on getting him to sleep through the night and re-examine the world once you yourself have have a decent stretch of sleep. Your pediatrician is a good resource, you don't have to figure out on your own.

You're very close to the age when my daughter FINALLY made good sleep a regular thing, and I promise you everything looks better and happier.

I wouldn't stop nursing at the same time that you work on sleep though. One change at a time.
posted by The Librarian at 6:28 AM on February 11, 2021 [1 favorite]

So I am in the opposite situation but I think the same logic applies. I was worried about getting the vaccine because I am breastfeeding. Ultimately I was convinced to do it because, as a kind doctor pointed out, the choice was not vaccine or no vaccine, the choice was vaccine or maybe covid. And while we are still waiting on research about the vaccine... we already know covid is bad.
I see your situation as this: you are torn between continuing to breastfeed to maybe, at some point, possibly, to some extent provide some vaccine/antibody benefit to your baby... vs. stopping (or cutting back) and definitely providing a happier, better-rested caretaker.
Like others have said, don't underestimate how important your own well-being is in this relationship.
I will add, anecdotally, that with my older children there were times that I was DONE breastfeeding, and got a second wind after cutting down to a number and timing of feedings that worked for me. It's also ok to just stop.
posted by Viola Swamp at 11:03 AM on February 11, 2021