Infant Vaccines and Breastfeeding

By Krista Gray, IBCLC. Last updated July 27, 2017.

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Do Breastfed Babies Need Vaccines?

New mothers often ask if their breastfed baby needs vaccines.  In short, vaccine recommendations are the same for all infants regardless of breastfeeding or formula feeding.  Breastfeeding need not be delayed or postponed before, during, or after immunizations either. In fact, research has shown that babies have reduced pain when breastfed during an immunization. 1  Breastfeeding is also associated with a reduced risk of incidence of fever after vaccinations. 2

The Center for Disease Control and Prevention (USA) states:

Neither inactivated nor live vaccines administered to a lactating woman affect the safety of breast-feeding for mothers or infants.  Breast-feeding does not adversely affect immunization and is not a contraindication for any vaccine. Limited data indicate that breast-feeding can enhance the response to certain vaccine antigens.  Breast-fed infants should be vaccinated according to routine recommended schedules. 3

The National Healthcare System in the United Kingdom states:

Immunity in newborn babies is only temporary and starts to decrease after the first few weeks or months. Breast milk also contains antibodies, which means that babies who are breastfed have passive immunity for longer. Colostrum is particularly rich in antibodies.  Premature babies are at higher risk of developing an illness because their immune systems are not as strong and they have not had as many antibodies passed to them.  As newborn immunity is only temporary, it is important to begin childhood immunisations when your baby is two months old. This applies to babies who are either premature or full-term. 4

What is Passive Immunity and How Long Does it Last?

Breastfeeding confers passive immunity to babies for many diseases and illnesses through its many immunological properties.  However, passive immunity is only temporary (during lactation) and is not a substitute for a baby’s own system to have active immunity to diseases and illnesses.  Breastfeeding not only confers passive immunity but also enhances a baby’s immune system and its ability to respond better to both vaccines and infections. 5

What Vaccine Schedule Should I Follow?

In the United States, the Centers for Disease Control and Prevention publish the most recent immunization schedules online.

What if My Baby is Born Preterm?

With the exception of Hepatitis B, the CDC recommends that it is safe for preterm babies to follow the same vaccine schedule as full-term babies. They recommend that for babies born under 2000 grams, it is preferable to wait until the baby is one month or has gained a considerable amount of weight and is ready for hospital discharge.  However, if a preterm baby is born to a mother testing positive to Hepatitis B, the vaccine should be given within the first 12 hours, though this dose should not count toward the three doses that will still need to be given. 6 The NHS in the UK also states that preterm babies should continue with the regular vaccine schedule.

Should I Breastfeed During an Immunization?

Yes!  Breastfeeding while your baby gets any vaccination is great pain relief and very comforting.  Research has shown that babies cry less both during and after immunizations when they are held in skin-to-skin contact and breastfed when they receive them.7  Breastfeeding is a wonderful way to help ease the pain or anxiety of your infant when she is vaccinated.

For additional information, you may be interested in Maternal Vaccines and How Medications Affect Baby.

Show 7 footnotes

  1. Shah, V. et al. (2009) Effectiveness and tolerability of pharmacologic and combined interventions for reducing injection pain during routine childhood immunizations: systematic review and meta-analyses. Clinical Therapeutics, 31(Suppl 2), S104-51.
  2. Pisacane, A. et al. (2010) Breastfeeding and Risk for Fever After Immunization. American Academy of Pediatrics. Accessed 25 September 2013 via www.pediatrics.org/cgi/doi/10
  3. Centers for Disease Control and Prevention (2002) “General Recommendations on Immunization – Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP)” Febr 8, 2002/51(RR02);1-36. Accessed 24 September 2013 via www.cdc.gov/breastfeeding/recommendations/vaccinations.htm.
  4. NHS Choices (2013) How long do babies carry their mother’s immunity? Accessed 25 September 2013 via http://www.nhs.uk/chq/Pages/939.aspx?CategoryID=54&SubCategoryID=135.
  5. Hanson, LA. (1999) Breastfeeding provides passive and likely long-lasting active immunity. Annals of Allergy Asthma & Immunology 1999 May;82(5):478. http://www.ncbi.nlm.nih.gov/pubmed/9892025.
  6. Centers for Disease Control and Prevention (2002) “General Recommendations on Immunization – Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP)” Febr 8, 2002/51(RR02);1-36. Accessed 24 September 2013 via www.cdc.gov/breastfeeding/recommendations/vaccinations.htm.
  7. Abdel Razek, A. & Az El-Dein, N. (2009). Effect of breast-feeding on pain relief during infant immunization injections. Int J Nurs Pract, Apr 15(2):99-104.
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