Is Diphtheria-Tetanus-Pertussis Vaccines safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Diphtheria-Tetanus-Pertussis Vaccines. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
Breastfeeding can enhance the response of the infant to certain vaccine antigens,[ 1 , 16 ] including tetanus toxoid and pertussis.[ 17 , 18 ] Breastfed infants are also less likely to have fever and may be less likely to experience anorexia and reduced energy intake after routine childhood immunization than those who are not breastfed.[ 19 , 20 ] A study in the United States of mothers who did not receive Tdap vaccine during pregnancy found that their infants who received breastmilk with 1 formula feeding or fewer daily decreased pertussis risk by about 75% compared with infants receiving more formula.[ 18 ] One study of previously vaccinated infants found that at 21 to 40 months of age breastfed infants had higher IgG levels against diphtheria, higher secretory IgA levels in saliva against diphtheria and tetanus and higher fecal IgM against tetanus than formula-fed infants.[ 21 ] A case-control study in Brazil found that exclusive breastfeeding of infants under 6 months of age protected them against pertussis-like illness. Protection was enhanced if the mother had been vaccinated against pertussis during pregnancy.[ 22 ] A study in Sweden compared the IgG response to diphtheria, tetanus and pertussis vaccine in infants who were either breastfed or randomized to one of 3 different formulas. In a secondary analysis of the results, breastfed infants had significantly lower IgG levels against diphtheria and pertussis at 6, and 12 months than formula-fed infants. A significantly higher proportion of the formula-fed infants showed diphtheria IgG concentrations above the protective levels at 6, and 12 months. For tetanus, proportions of infants above the protective levels were similar for formula-fed and breastfed infants. The authors could not explain the differences, but felt that the clinical relevance of different IgG responses is most likely limited.[ 23 ]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Thirty-nine women who were within 24 hours postpartum received 0.5 mL of Tdap vaccine (Adacel, Sanofi Pasteur) and 11 received no vaccine. Colostrum or breast milk and blood samples were collected at baseline and 7, 10, 14, and 28 days after vaccination. Breastmilk IgA levels against pertussis toxoid peaked at day 10 postpartum, then slowly decreased. Breast milk antibody levels against the other antipertussis vaccine components, filamentous hemagglutinin and fimbriae types 2 and 3, reached a plateau during days 10 to 14 and then slowly decreased. Breast milk antibody levels against another antipertussis vaccine component, pertactin, peaked on day 14 and then decreased by day 28.[ 9 ] The milk of 25 pregnant women given Tdap vaccine (Boostrix, GlaxoSmithKline) after 20 weeks of pregnancy was compared to colostrum from 12 unvaccinated women. Milk samples were collected prior to discharge after delivery (colostrum) and at 2, 4 and 8 weeks postpartum. Vaccinated women had significantly higher antipertussis antibody levels in their breastmilk than unvaccinated women. The primary class of immunoglobulins was IgA, which were highest in colostrum, but still detectable at 8 weeks.[ 10 ] Total and anti-pertussis toxin secretory IgA (sIgA) levels were measured in breastmilk from women who had been vaccinated either during pregnancy (n = 19), at or shortly after delivery (n = 34), less than 5 years before delivery (n = 9), or more than 5 years before delivery (n = 12). Tdap vaccine (Boostrix, GlaxoSmithKline) was used in the first 3 groups. Breastmilk samples were obtained between 44 and 91 days postpartum. No difference in total sIgA was found between the groups, but women who were vaccinated during pregnancy or shortly after birth had higher anti-pertussis toxin levels of sIgA than those vaccinated more than 5 years before. Higher anti-pertussis toxin sIgA levels were found among women practicing mixed feeding than among exclusively breastfeeding mothers.[ 1
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.