I’m a breastfeeding new mom. Despite lack of data, I’m getting in line for the COVID vaccine.

When I was 16 weeks pregnant in March 2020, California declared a shelter-in-place order because of the coronavirus outbreak. In the ensuing days, weeks and months, I voraciously read about how this deadly virus might affect pregnant women and their unborn babies. I constantly refreshed my news feed as information came in. I lived with constant anxiety and fear about how to ensure my baby’s safety at a time of extreme uncertainty.

So when my daughter was born in September, I was finally able to take a deep breath. After laboring in a mask, she had arrived and we were both healthy.

Luckily, shortly after she was born, she latched onto my breast. Both the American Academy of Pediatrics (AAP) and World Health Organization (WHO) recommend that babies are exclusively breastfed for at least the first six months of their life given the well-known health benefits of breastfeeding.

In the United States, more than 84% of babies born in 2017 were breastfed at some point and 58% of babies were breastfed at six months, according to the Centers for Disease Control and Prevention (CDC).

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In the months after my daughter’s birth, protecting a newborn from a deadly pandemic was an ever-constant concern. So I breathed another sign of relief when the Food and Drug Administration (FDA) approved two COVID-19 vaccines — Pfizer and Moderna — in December.

New mothers going alone

Unfortunately, I quickly learned that there is virtually no data on the safety of these vaccines for breastfeeding women like me. Both Pfizer and Moderna did not actively include breastfeeding women in their initial clinical trials. Because of a lack of data, governments in other countries, like the United Kingdom and Russia, have recommended breastfeeding mothers not take the COVID-19 vaccine.

The FDA, CDC, WHO, American Association of Obstetricians and Gynecologists and the Academy of Breastfeeding Medicine (ABM) have all stated that the approved coronavirus vaccines may be offered to lactating women. These organizations generally suggest that vaccine eligible breastfeeding mothers should discuss the potential benefits and risks with their health care provider and then decide whether to take the vaccine.

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Most experts agree that the approved COVID-19 vaccines are safe for breastfeeding mothers. In the opinion of ABM, there is “little biological plausibility that the vaccine will cause harm.” According to the CDC, mRNA vaccines, like the Pfizer and Moderna ones, “are not thought to be a risk to the breastfeeding infant.”

As the benefits to protecting women against contracting COVID-19 outweigh the potential risk, experts recommend that women who are vaccinated continue breastfeeding. One study even suggests that such vaccines may offer protection to infants by passing on antibodies to counter the virus.

Why were new mothers excluded?

Based on this, I will take the vaccine once I am given the option and continue breastfeeding. But it is important to recognize the predicament that new mothers who choose to breastfeed find themselves in.

An immense mental health strain has been placed on pregnant women and new mothers in this pandemic. We have experienced great uncertainty in regard to how the virus will affect our bodies and our future babies.

Based on the way the mRNA vaccines work, experts argue there is little risk for breastfeeding moms to be vaccinated. But if the safety of breastfeeding women with these types of vaccines is generally accepted, it is hard to understand why this group was excluded from trials.

Katie Reilly in Berkeley, California, in October 2018.

To avoid this quandary, lactating women must be included earlier in future trials. “We must protect pregnant and breastfeeding people through research, not from research,” ABM wrote in a statement. In a Committee Opinion, the American Association of Obstetricians and Gynecologists wrote that “all women … should be presumed eligible for participation in research studies.”

When it is my turn, I will take the vaccine, but it will be hard to fully ignore the uncertainty of risk that remains. Hopefully, lactating women will not needlessly be placed in this position again.

Katie C. Reilly is a writer and attorney. Her work primary focuses on women’s health and social justice issues. Follow her on Twitter: @KatieCReilly1

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