Breastfeeding and COVID-19: From Nutrition to Immunity

Vassilopoulou, Εmilia; Feketea, Gavriela; Koumbi, Lemonica; Mesiari, Christina; Berghea, Elena Camelia; Konstantinou, George N.

doi:10.3389/fimmu.2021.661806

Cited by 59 publications

(53 citation statements)

References 73 publications

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“…sIgA is the most abundant antibody in breast milk that provides adequate specific protection against pathogens, including viruses. The specificity of sIgA depends on the maternal immune response to previous infection, which probably explains the low infection rate or milder symptoms seen in infected infants breastfed by mothers infected with SARS-CoV-2 [ 14 ]. A similar mechanism can be involved in the immune response after maternal vaccination [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Immune Response to Vaccination against COVID-19 in Breastfeeding Health Workers

et al. 2021

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Background: Initially, there were no data on the safety of COVID-19 vaccines in lactating women. The aim of our study was to evaluate the immune response to COVID-19 vaccinations in breastfeeding women. Methods: The study included 32 breastfeeding women who, regardless of the study, had decided to be vaccinated. Maternal serum and breast milk samples were simultaneously collected on days 8 ± 1, 22 ± 2, 29 ± 3, and 43 ± 4 after the first dose of the vaccine. The immune response was assessed by determining the presence of anti-SARS-CoV-2 IgG and IgA. Results: The breast milk IgG level was detectable (6.50 ± 6.74, median 4.7, and maximum 34.2 BAU/mL) and highly correlated to serum IgG level (rS 0.89; p < 0.001). The breast milk ratio of IgA to the cut-off value was higher in serum IgA-positive (4.18 ± 3.26, median 2.8, and maximum >10) than in serum IgA-negative women (0.56 ± 0.37, median 0.5, and maximum 1.6; p < 0.001). The highest concentrations of serum and breast milk antibodies were observed on day 29 ± 3 with a decrease on day 43 ± 4. Conclusion: The immune response to the vaccination against SARS-CoV-2 is strongest 7 ± 3 days after the second dose of the vaccine. Lactating mothers breastfeeding their children after vaccination against SARS-CoV-2 may transfer antibodies to their infant.

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Section: Discussionmentioning

confidence: 99%

Immune Response to Vaccination against COVID-19 in Breastfeeding Health Workers

et al. 2021

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“…This study reported that all breast milk samples were free of SARS-CoV-2 regardless of whether SARS-CoV-2 was positive or negative in specimens from the upper respiratory tract confirming previous reports. 31,32 In contrast, several earlier studies reported positive detection of SARS-CoV-2 RNA in breast milk from mothers with COVID-19. [33][34][35][36] Such conflicting data indicate that more comprehensive studies are required before advocating that breastfeeding is unsafe for mothers with confirmed or suspected infection with COVID-19.…”

Section: Discussionmentioning

confidence: 88%

Breastfeeding in Mothers with COVID-19: Insights from Laboratory Tests and Follow-Up from Early Outbreak of the Pandemic in China

Luo

Xia

Yao

et al. 2021

Journal of Women's Health

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Objective: The outbreak of Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) threatens a surging number of community groups within society, including women actively breastfeeding. Breastfeeding involves intimate behaviors, a major transmission route of SARS-CoV-2, and is integral to the close mother-baby relationship highly correlated with maternal psychological status. Materials and Methods: Twenty-three pregnant women and puerperae with either confirmed or suspected diagnoses of COVID-19 were enrolled in the study. The clinical characteristics and outcomes of the mothers and neonates were recorded. The presence of SARS-CoV-2, IgG, and IgM in breast milk, maternal blood, and infant blood, together with feeding patterns, was assessed within 1 month after delivery. Feeding patterns and maternal psychological status were also recorded in the second follow-up. Results: No positive detection of SARS-CoV-2 was found in neonates. All breast milk samples were negative for the detection of SARS-CoV-2. The presence of IgM for SARS-CoV-2 in breast milk was correlated with IgM presence in the maternal blood. The results of IgG detection for SARS-CoV-2 were negative in all breast milk samples. All infants were in a healthy condition in two follow-ups, and antibody tests for SARS-CoV-2 were negative. The rate of breast milk feeding increased during two follow-ups. All mothers receiving a second follow-up experienced negative psychological factors and status. Conclusions: Our findings support the feasibility of breastfeeding in women infected with SARS-CoV-2. The additional negative psychological status of mothers due to COVID-19 should also be considered during the puerperium period.

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“…The beneficial properties of breastfeeding including the practice of skin-to-skin care and the transfer of protective maternal antibodies via breast milk (especially secretory IgA (sIgA) and, to a lesser extent, IgM and IgG isotype immunoglobulins) are well established [22]. Recent evidence indicates that breastfeeding does not seem to be associated with neonatal SARS-CoV-2 infection because viral transmission through the milk, if any, should be rare [23] and because a robust sIgA-dominant SARS-CoV-2 antibody response is detectable in human milk soon after infection in a significant majority of individuals [24], suggesting a possible protection granted by the mothers to their infants [25][26][27][28][29][30]. Moreover, there is evidence in vitro suggesting whey proteins in human breastmilk as a direct-acting inhibitor of SARS-CoV-2 infection and replication [31].…”

Section: Discussionmentioning

confidence: 99%

Consequences of Early Separation of Maternal-Newborn Dyad in Neonates Born to SARS-CoV-2 Positive Mothers: An Observational Study

Conti

Natale

Stolfi

et al. 2021

IJERPH

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As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continues its spread all over the world, data on perinatal management of the maternal-infant dyad are urgent. We performed an observational study to describe the effects of the early separation of the maternal-infant dyad, in case of maternal SARS-CoV-2 infection. We reported the medical records for 37 neonates born to 37 SARS-CoV-2 positive mothers in a setting of separation of the dyad after birth. Data on neonatal infection, clinical condition, and breastfeeding rate were recorded until the first month of life. No maternal deaths were recorded; 37.8% of women had at least one pregnancy-related complication. We reported a high adherence to recommended safety measures after discharged with 84.8% of the mothers using at least one personal protective device and 51.5% using all the protective devices. We reported one case of vertical transmission and no cases of horizontal transmission. However, the separation of the dyad had a negative impact on breastfeeding because only 23.5% of the newborns received exclusively human milk during the first month of life. Despite early separation of the dyad protecting the newborns from possible horizontal transmission of SARS-CoV-2, it negatively affects breastfeeding during the first months of life.

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Breastfeeding and COVID-19: From Nutrition to Immunity

Cited by 59 publications

References 73 publications

Immune Response to Vaccination against COVID-19 in Breastfeeding Health Workers

Immune Response to Vaccination against COVID-19 in Breastfeeding Health Workers

Breastfeeding in Mothers with COVID-19: Insights from Laboratory Tests and Follow-Up from Early Outbreak of the Pandemic in China

Consequences of Early Separation of Maternal-Newborn Dyad in Neonates Born to SARS-CoV-2 Positive Mothers: An Observational Study

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