Human Milk from Previously COVID-19-Infected Mothers: The Effect of Pasteurization on Specific Antibodies and Neutralization Capacity

Keulen, Britt J. van; Romijn, Michelle; Bondt, Albert; Dingess, Kelly A.; Kontopodi, Eva; Straten, Karlijn van der; Boer, Maurits A. den; Burger, Judith A.; Poniman, Meliawati; Bosch, Berend Jan; Brouwer, Philip J.M.; Groot, Christianne de; Hoek, Max; Li, Wentao; Pajkrt, Dasja; Sanders, Rogier W.; Schoonderwoerd, Anne; Tamara, Sem; Timmermans, R.A.H.; Vidarsson, Gestur; Stittelaar, Koert J.; Rispens, Theo; Hettinga, Kasper; Gils, Marit J. van; Heck, Albert J. R.; Goudoever, Johannes B. van

doi:10.3390/nu13051645

Cited by 58 publications

(69 citation statements)

References 32 publications

(35 reference statements)

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“…Consistent with previous reports [21], we found high variability in human milk SARS-CoV-2-specific IgA levels in previously infected participants, with some of them having no milk conversion over the entire study period. In contrast, almost all vaccinated participants showed milk conversion.…”

Section: Discussionsupporting

confidence: 92%

“…Our findings are in line with previous research on serum where IgA levels were similar following infection or vaccination [18]. In human milk, the IgA response was studied separately following infection or vaccination [19][20][21], but only a few studies compared both exposure types longitudinally. In one study, higher IgA levels were observed in human milk of previously infected participants at day 12 versus those in vaccinated participants 47 days after receiving the first dose [22].…”

Section: Discussionsupporting

confidence: 90%

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Comparison of SARS-CoV-2-Specific Antibodies in Human Milk after mRNA-Based COVID-19 Vaccination and Infection

et al. 2021

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SARS-CoV-2-specific antibodies are secreted into human milk of infected or vaccinated lactating women and might provide protection to the breastfed infant against COVID-19. Differences in antibody response after these types of exposure are unknown. In this longitudinal cohort study, we compared the antibody response in human milk following SARS-CoV-2 vaccination or infection. We analyzed 448 human milk samples of 28 lactating women vaccinated with the SARS-CoV-2 vaccine BNT162b2 as well as 82 human milk samples of 18 lactating women with a prior SARS-CoV-2 infection. The levels of SARS-CoV-2-specific IgA in human milk were determined over a period of 70 days both after vaccination and infection. The amount of SARS-CoV-2-specific IgA in human milk was similar after SARS-CoV-2 vaccination and infection. After infection, the variability in IgA levels was higher than after vaccination. Two participants with detectable IgA prior to vaccination were analyzed separately and showed higher IgA levels following vaccination compared to both groups. In conclusion, breastfed infants of mothers who have been vaccinated with the BNT162b2 vaccine receive human milk with similar amounts of SARS-CoV-2-specific antibodies compared to infants of previously infected mothers.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Comparison of SARS-CoV-2-Specific Antibodies in Human Milk after mRNA-Based COVID-19 Vaccination and Infection

et al. 2021

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“…Research to date suggests that severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is not transmitted in breast milk [1][2][3]. Instead, there is evidence that antibodies to SARS-Cov-2 isolated in breast milk have a strong immunological response against the virus [4][5][6]. Therefore, it is globally recommended that women continue to breastfeed to improve their infants' health and immunity during the pandemic [7,8].…”

Section: Introductionmentioning

confidence: 99%

Wellbeing of Breastfeeding Women in Australia and New Zealand during the COVID-19 Pandemic: A Cross-Sectional Study

et al. 2021

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During the COVID-19 pandemic, breastfeeding women have experienced restricted access to support, placing them at increased risk of mental health concerns and limited breastfeeding assistance. This study investigated the effect of the pandemic on feeding choices and maternal wellbeing amongst breastfeeding mothers living in Australian and New Zealand. We conducted a cross-sectional online survey that examined feeding methods, maternal mental wellbeing, worries, challenges, and positive experiences during the pandemic. Most women were exclusively breastfeeding (82%). Partial breastfeeding was associated with perceived low milk supply and longer pregnancy duration during the pandemic. Reduced mental health and wellbeing was associated with lower levels of family functioning, increased perceived stress, and perinatal anxiety. Longer pregnancy duration during the pandemic was associated with lower mental health wellbeing scores, while higher perceived stress scores were reported for regions with higher COVID-19 infection rates and women with perceived low milk supply. Women reported that the pandemic resulted in less pressure and more time for family bonding, while worries about the pandemic, family health, and parenting challenges were also cited. Mental health concerns of breastfeeding women appear to be exacerbated by COVID-19, highlighting a critical need for access to mental health and broader family support during the pandemic.

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“…For example, 94% of human milk samples from lactating parents who recovered from COVID-19 exhibited pseudo-neutralization activity, while only 18% exhibited neutralization activity against wild-type virus. 7 Herein, we compare the temporal pattern and neutralizing activity of anti-SARS-CoV-2 antibodies in human milk following natural COVID-19 infection vs SARS-CoV-2 mRNA vaccination. We further assessed human milk ability to neutralize live wild-type virus from each group.…”

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confidence: 99%

Association of Human Milk Antibody Induction, Persistence, and Neutralizing Capacity With SARS-CoV-2 Infection vs mRNA Vaccination

et al. 2022

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IMPORTANCELong-term effect of parental COVID-19 infection vs vaccination on human milk antibody composition and functional activity remains unclear.OBJECTIVE To compare temporal IgA and IgG response in human milk and microneutralization activity against SARS-CoV-2 between lactating parents with infection and vaccinated lactating parents out to 90 days after infection or vaccination.DESIGN, SETTING, AND PARTICIPANTS Convenience sampling observational cohort (recruited July to December 2020) of lactating parents with infection with human milk samples collected at days 0 (within 14 days of diagnosis), 3, 7, 10, 28, and 90. The observational cohort included vaccinated lactating parents with human milk collected prevaccination, 18 days after the first dose, and 18 and 90 days after the second dose.EXPOSURES COVID-19 infection diagnosed by polymerase chain reaction within 14 days of consent or receipt of messenger RNA (mRNA) COVID-19 vaccine (BNT162b2 or mRNA-1273). MAIN OUTCOMES AND MEASURESHuman milk anti-SARS-CoV-2 receptor-binding domain IgA and IgG and microneutralization activity against live SARS-CoV-2 virus. RESULTSOf 77 individuals, 47 (61.0%) were in the infection group (mean [SD] age, 29.9 [4.4] years), and 30 (39.0%) were in the vaccinated group (mean [SD] age, 33.0 [3.4] years; P = .002). The mean (SD) age of infants in the infection and vaccinated group were 3.1 (2.2) months and 7.5 (5.2) months, respectively (P < .001). Infection was associated with a variable human milk IgA and IgG receptor-binding domain-specific antibody response over time that was classified into different temporal patterns: upward trend and level trend (33 of 45 participants [73%]) and low/no response (12 of 45 participants [27%]). Infection was associated with a robust and quick IgA response in human milk that was stable out to 90 days after diagnosis. Vaccination was associated with a more uniform IgG-dominant response with concentrations increasing after each vaccine dose and beginning to decline by 90 days after the second dose. Vaccination was associated with increased human milk IgA after the first dose only (mean [SD] increase, 31.5 [32.6] antibody units). Human milk collected after infection and vaccination exhibited microneutralization activity. Microneutralization activity increased throughout time in the vaccine group only (median [IQR], 2.2 [0] before vaccine vs 10 [4.0] after the first dose; P = .003) but was higher in the infection group (median [IQR], 20[67] at day 28) vs the vaccination group after the first-dose human milk samples (P = .002). Both IgA and non-IgA (IgG-containing) fractions of human milk from both participants with infection and those who were vaccinated exhibited microneutralization activity against SARS-CoV-2. CONCLUSIONS AND RELEVANCEIn this cohort study of a convenience sample of lactating parents, the pattern of IgA and IgG antibodies in human milk differed between COVID-19 infection vs mRNA vaccination out to 90 days. While infection was associated with a highly variable IgA-dominant response a...

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Human Milk from Previously COVID-19-Infected Mothers: The Effect of Pasteurization on Specific Antibodies and Neutralization Capacity

Cited by 58 publications

References 32 publications

Comparison of SARS-CoV-2-Specific Antibodies in Human Milk after mRNA-Based COVID-19 Vaccination and Infection

Comparison of SARS-CoV-2-Specific Antibodies in Human Milk after mRNA-Based COVID-19 Vaccination and Infection

Wellbeing of Breastfeeding Women in Australia and New Zealand during the COVID-19 Pandemic: A Cross-Sectional Study

Association of Human Milk Antibody Induction, Persistence, and Neutralizing Capacity With SARS-CoV-2 Infection vs mRNA Vaccination

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