Influenza Vaccine use while Breastfeeding

Influenza Vaccine Levels and Effects while Breastfeeding

Summary of Use during Lactation

The Centers for Disease Control and Prevention and several health professional organizations state that vaccines given to a nursing mother do not affect the safety of breastfeeding for mothers or infants and that breastfeeding is not a contraindication to either the live, attenuated (i.e., inhaled) or inactivated (i.e., injected) influenza vaccine, including H1N1 (swine) influenza vaccine. Immunization of the mother during the third trimester of pregnancy increases the amount of influenza antibodies in breastmilk and protects their breastfed infants against influenza.[1][2] Breastfed infants should be vaccinated according to the routine recommended schedules.[3][4][5][6]

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Limited data indicate that breastfeeding can enhance the response of the infant to certain vaccine antigens.[3][5][7]

In a study of pregnant women who were immunized during the third trimester and breastfed their infants for an average of 14 weeks, their infants had a 36% reduction in respiratory illness with fever, and a 63% reduction in laboratory-confirmed influenza during the first 6 months of life. However, the contribution of breastfeeding compared with passive transfer of maternal antibodies during pregnancy was not determined.[8]

A prospective, blinded trial in Bangladesh compared outcomes of mothers randomly assigned to receive either trivalent influenza vaccine or pneumococcal polysaccharide vaccine in the third trimester of pregnancy and their infants. Influenza-specific IgA levels were higher in the breastmilk of those immunized against influenza than pneumococcus until at least 6 months postpartum. The breastfed infants of influenza-vaccinated mothers had fewer episodes of respiratory illness with fever in the first 6 months postpartum, which was positively correlated with the extent of exclusive breastfeeding.[2]

Possible Effects on Lactation

Relevant published information was not found as of the revision date.

References

1. Maertens K, De Schutter S, Braeckman T et al. Breastfeeding after maternal immunisation during pregnancy: Providing immunological protection to the newborn: A review. Vaccine. 2014;32:1786-92. PMID: 24530929

2. Schlaudecker EP, Steinhoff MC, Omer SB et al. IgA and neutralizing antibodies to influenza a virus in human milk: a randomized trial of antenatal influenza immunization. PLoS One. 2013;8:e70867. PMID: 23967126

3. Anon. Human milk. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red Book: 2009 Report of the Committee on Infectious Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009.

4. Gruslin A, Steben M, Halperin S et al. Immunization in pregnancy: No. 220, December 2008. Int J Gynaecol Obstet. 2009;105:187-91. PMID: 19367691

5. General recommendations on immunization --- recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011;60 (RR-2):1-64. PMID: 21293327

6. Anon. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP)--United States, 2012-13 influenza season. MMWR Morb Mortal Wkly Rep. 2012 ;61:613-8. PMID: 22895385

7. Pabst HF. Immunomodulation by breast-feeding. Pediatr Infect Dis J. 1997;16:991-5. PMID: 9380478

8. Zaman K, Roy E, Arifeen SE et al. Effectiveness of maternal influenza immunization in mothers and infants. N Engl J Med. 2008;359:1555-64. PMID: 18799552

Influenza Vaccine Identification

Substance Name

Influenza Vaccine

Drug Class

  • Vaccines

Administrative Information

LactMed Record Number

146

Information from the National Library of Medicine's LactMed Database.

Last Revision Date

2014-04-01

Disclaimer

Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Disclaimer: This information is not intended as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. Use of this website signifies your agreement to the Terms of Use and Online Privacy Policy.

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