Thread by @VikiLovesFACS

A lot of people are asking me...

“I feel like my baby and I are coming towards the end of #breastfeeding. But I just got my #COVID19 #vaccine! Should I keep going to give my baby protection against COVID19?”

💉🤱🏾🧵 ...

(By the way, in this thread, I will say "breastfeeding" for short, but this also includes people who are giving their babies pumped breastmilk.) 2/

I have breastfed two babies myself and I know that stopping breastfeeding is *such* a personal thing. So I can’t possibly give a yes/no answer to that question. But what I can do is give you a framework for making your own decision... 3/

But first, let’s be clear that receiving the #COVID19 #vaccine is totally compatible with #breastfeeding. So don’t let anyone tell you that you have to stop BF if you get the vaccine. 4/

rcog.org.uk/en/guidelines-…

Now, let’s think about the benefits of breastfeeding after you have been vaccinated. The most important one is that *you* are protected from COVID! And healthy mums are important for healthy babies. 5/

But another one is the anti-COVID antibodies get into your breastmilk. Here are links to four studies showing this... 6/

medrxiv.org/content/10.110…

jamanetwork.com/journals/jama/…

medrxiv.org/content/10.110…

medrxiv.org/content/10.110…

Based on studies done with the flu vaccine, we might expect these antibodies to give your baby some protection from COVID, but we don’t know that for sure yet. 7/

journals.plos.org/plosone/articl…

It’s also important to think about *how* antibodies in breastmilk protect babies. They line the surface of the nose, mouth and gut to act as a first line of defence against (in this case) COVID. 8/

But there is flow at these surfaces, so to work well the antibodies have to be “topped up” regularly with more breastmilk. For this reason, we expect a baby who is getting milk every couple of hours to benefit more than one who is getting it less often. 9/

So immunity benefits of continuing to breastfeed after vaccination: probably some protection against COVID for your baby (though we can’t say for certain yet). And this protection will be greater in a baby who is getting breastmilk more often. 10/

But! We do also have to count in the potential downsides of continuing to breastfeed, and this is where it gets personal... 11/

If you and your baby are loving breastfeeding right now, then there is no downside. BF away! But maybe your baby has had enough of it. Maybe *you* have had enough of it! Maybe you both enjoy breastfeeding but you have gone back to work and now have to pump, which you hate. 12/

I firmly believe that these personal aspects need to be taken into account too. Especially given that the benefit of breastfeeding to your baby’s immunity is likely to be modest. So here’s my decision framework... 13/

You might be more willing to extend breastfeeding if your baby will be getting regular breastmilk feeds (the benefits are more) or if you are both really enjoying it anyway (the downsides are less). 14/

You might be less willing to extend breastfeeding if you baby will be getting only one or two feeds a day (the benefits are less) or if breastfeeding/pumping is something that one or both of you are not enjoying (the downsides are more). 15/

I hope this framework helps people to make these decisions. As always, happy to chat! \thread