Are Maternal Vaccines Safe While Breastfeeding?
Mothers often wonder if breastfeeding is compatible with medications, how drugs affect breast milk, and how medications in milk affect a baby. Vaccines are no different; before getting a vaccine most breastfeeding mothers want to ensure it will not negatively impact their milk or baby. While many breastfeeding mothers will never be faced with needing a vaccine while breastfeeding, others (due to international travel, endemic illness, etc.) will need one or more.
The CDC 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. . . . Although live vaccines multiply within the mother’s body, the majority have not been demonstrated to be excreted in human milk. Although rubella vaccine virus might be excreted in human milk, the virus usually does not infect the infant. If infection does occur, it is well-tolerated because the viruses are attenuated. Inactivated, recombinant, subunit, polysaccharide, conjugate vaccines and toxoids pose no risk for mothers who are breast-feeding or for their infants.” 1
Vaccines WITH Precautions for Breastfeeding
- Smallpox – contraindicated while breastfeeding
Vaccines Without Breastfeeding Precautions
- Immune globulins, including Rh immune globulin (RhoGAM)
- Hepatitis A – CDC states that no safety research is available. While it is most likely safe, consider administering the immune globulin instead of the vaccine.
- Hepatitis B
- Influenza (inactivated whole virus or subunit)
- Japanese Encephalitis – No data available regarding its safety during breastfeeding
- Meningococcal Meningitis
- Pneumococcal – No data available regarding its safety during breastfeeding though it is unlikely to cause any concern in breastfed baby.
- Polio, inactivated
- Rabies – No data available regarding its safety during breastfeeding though it is commonly given to breastfeeding mothers without observed problems in baby.
- Tuberculosis (BCG) – No data available regarding its safety while breastfeeding.
- Typhoid (Polysaccharide & Live bacterial) – No data available regarding its safety while breastfeeding, although CDC states it should be given in breastfeeding mothers when risk of exposure is high
- Yellow fever – Avoid administering to breastfeeding mothers unless travel to endemic areas is unavoidable. 2
What’s the Bottom Line?
While it is always best to not have to take any type of drug, medication, and/or vaccine while breastfeeding, all vaccines are considered safe if necessary with the exception of Smallpox. There are many well-documented health consequences associated with formula, even for a short duration. Therefore, when a vaccine is necessary in a breastfeeding mother it should not be a cause of breastfeeding concern or reason for supplementation and/or early weaning.
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