She sounded genuine, but as she looked my 17-month-old up and down, I could guess what she was thinking: ‘Isn’t she getting a little old for that?’
As parents wait for a coronavirus vaccine to be available to children under 5, some mothers have been delaying weaning — and I’m one of them. Not that 17 months (and counting) is out of the norm for breastfeeding; in fact, the World Health Organization recommends breastfeeding children up to 2 years old and beyond. Still, a year and a half is much longer than all my mom friends nursed their kids. (Less than 16 percent of US moms are still breastfeeding by 18 months.) And to be frank, it’s a lot longer than I planned.
But between my daughter’s birth in summer 2020 and getting vaccinated against the coronavirus in early 2021, I made it my goal to continue to breastfeed until my baby could get vaccinated, too. I know that not every parent is able to breastfeed, and many of those who do aren’t able to go so long. But I felt lucky to not run into any problems nursing and felt encouraged to keep going.
“Breast milk is loaded with antibodies and other factors that protect infants,” says Grace M. Aldrovandi, chief of the division of infectious diseases at UCLA Mattel Children’s Hospital. “When a mother gets an infection, antibodies and immune cells traffic to the milk.”
Vaccinated mothers pass covid antibodies to babies in utero and through breastmilk, early studies show
Breast milk can help babies fight off respiratory infections, she explains, but because of the newness of covid-19, experts don’t know for sure if the same will apply. “We know that giving adults antibodies can prevent covid,” Aldrovandi says. “Breast milk containing SARS-CoV-2 antibodies probably works in a similar fashion. Some people consider breast milk antibodies to be nature’s first vaccine.”
While the omicron variant, which made up 95 percent of covid cases in early January, has reportedly been less severe for adults, children (many of whom are still not eligible for vaccination) might not be as lucky. “Rates of hospitalization for children have skyrocketed to the highest levels of the pandemic,” Aldrovandi warns. “Covid is among the top 10 causes of deaths among children in the US It is heartbreaking and we know that at least in the short term, the numbers are going to increase.” In addition, research published in January linked adolescent covid infection with an increased risk of Type 1 diabetes.
My toddler hasn’t had play dates during the pandemic. Is that okay?
Luckily, a small study from the University of Rochester of 77 lactating parents found that mothers in the study with covid-19 antibodies (whether from an mRNA vaccine or from a covid-19 infection) produced breast milk with active SARS-CoV-2 antibodies . While previous research has found covid antibodies in breast milk, this study found antibodies actually neutralized live SARS-CoV-2 virus.
“It’s one thing to just measure antibodies in milk,” says Bridget Young, a human milk scientist at the University of Rochester School of Medicine and Dentistry, and one of the authors on the study. “But when you measure antibodies in any fluid, you don’t know if they’re actually active, if they’re able to do their job.”
Still, this doesn’t necessarily mean that these antibodies will protect the recipient child. “Keeping an infection from forming in a dish in a lab gives us a pretty good indication it’s probably helpful for the baby, but of course, we didn’t do this with live babies,” Young says.
Another study, this one from the University of Massachusetts Amherst of 30 lactating women, was the first to study the stool of infants of vaccinated mothers, finding SARS-CoV-2 antibodies in the samples. Again, this suggests vaccinated mothers could be giving their babies passive immunity against the virus.
Plus, another study from Santa Cruz, Spain, of 122 mothers found that the covid antibodies seemed to get stronger the longer the women in the study breastfed. “The antibody concentrations in the milk of mothers who were breastfeeding 24 months were significantly higher than in mothers with breastfeeding periods <24 months,” says the study.
“Our study stresses the importance of immunoglobulins passing through breast milk, even in older children who are still breastfeeding. Breast milk is a living element that protects our children regardless of their age,” explained one of the authors of this study, Dolores Sabina Romero Ramírez, a neonatologist at the Nuestra Señora de Candelaria in Santa Cruz de Tenerife.
It’s not clear whether the older babies, who were receiving more antibodies, were gaining more protection from covid-19, but Romero Ramírez seemed hopeful. “This data points to a possible route of infant protection against the virus,” she said, adding that the team will learn more over time with follow-up studies of these mothers and children.
But even if antibodies in milk do help protect against the virus, it’s unclear whether they will help fight off the omicron variant. With Pfizer, Moderna and Johnson & Johnson booster shots protecting against severe illness, perhaps one could assume that milk antibodies from these vaccines would do the same.
Young explains that we just don’t have the data yet, adding that her research took place before the delta and omicron variants came to be. But she points out that, if breast milk doesn’t help protect against covid or any of the variants, breast milk can still help children fight off illness.
“There are other things in breast milk that are antimicrobial in general,” Young said. “We know one of the main reasons that breastfeeding is universally recommended is it provides a generalized immune protection, particularly against upper respiratory infections for the recipient baby.”
Shortly after that day at the neighborhood park, I watched in horror as covid numbers continued to rise. In my home state of California, cases skyrocketed, with more than 130,000 in just one day. My family started strictly quarantining, just like we did before we were vaccinated. I was once again terrified for my daughter, hoping we could continue to avoid the virus. So far, we have.
Two years into the pandemic, I didn’t think case counts would be so high and I didn’t think I’d still be so worried about my daughter getting sick. Still, the scientific community has made a lot of progress, and parents like me have a lot to be thankful for: promising studies about breastfeeding and hopefully a vaccine for small children soon.
“Breastfeeding is a beautiful relationship between mother and child,” said Maria Fernandez, a registered nurse lactation consultant based in Bethpage, NY. “If you are able to provide protection to your child from a virus that has taken so many loved ones from way too many families, you are already creating a better tomorrow with the ability to fight, and perhaps eradicate, covid.”
For now, I’m continuing to nurse, hoping for the best. “Breastfeeding is the first vaccine,” Romero Ramírez said. “And it will probably continue to contribute to the protection of children, along with the vaccines they will receive.”
Jillian Pretzel is a California-based writer and mother of one. Find her online at jillianpretzel.com.
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