背景
Most vaccines can safely be administered to people who are breastfeeding.
Receiving vaccines while breastfeeding offers the benefits of both getting protection from certain vaccine-preventable diseases and decreasing the potential of transmitting the diseases to others (including the infant). Additionally, maternal antibodies have been found in breastmilk suggesting that some passive immunity (short-term protection from donated antibodies) can also be transferred to the infant.
Vaccinating people who are breastfeeding does not diminish the volume or quality of breastmilk produced. Conversely, lactation can be impacted when a breastfeeding person becomes unwell (such as with a vaccine-preventable disease).
建议
People who are breastfeeding should be up to date with the vaccines recommended on the 国家免疫计划 (NIP). Additional risk factors such as travel, occupation and underlying medical conditions may also mean that further vaccines or additional doses are recommended.
A person does not need to stop breastfeeding before or after they receive a vaccine.
Where a 孕 person has been found to be seronegative (not immune) to 麻疹, mumps, rubella or 水痘, these vaccines can be administered post-partum while breastfeeding (noting that live-attenuated vaccines are contraindicated during pregnancy).
People who are breastfeeding should be up to date with the current annual 流感 vaccine. If they did not receive any influenza vaccine while pregnant, or if the influenza vaccine they received during pregnancy was for the previous year’s influenza season, they should be vaccinated while breastfeeding. Vaccination protects both the vaccine recipient and the breastfeeding infant. This is important to provide some protection to the infant before they can receive their own influenza vaccination from 6 months of age.
防范措施
Rubella
It is safe to administer rubella vaccines to people who are breastfeeding. In rare cases the live-attenuated 疫苗 virus may be secreted in breastmilk. If this occurs, the breastfeeding infant may experience mild symptoms associated with rubella 或者 no symptoms at all. For more information, go to Australian Immunisation Handbook: Rubella.
乙型肝炎
It is safe for a person who is positive for the 乙型肝炎 virus to breastfeed their infant as long as the infant has received hepatitis B immunoglobulin (HBIG) and a birth dose of hepatitis B vaccine. These are recommended, and ideally administered on the day of birth (preferably within 12 hours), at the same time, in separate thighs. HBIG needs to be administered within 48 hours after birth (efficacy is significantly reduced if administration is delayed > 48 hours after birth) and the vaccine up to 7 days after birth. The routine scheduled 3 dose course of hepatitis B vaccine should also be completed at 6 weeks, 4 months and 6 months (as per the NIP).
The infant should have serology performed 3 to 12 months post the 6-month dose of hepatitis B vaccine.
黄热病
Administering 黄热病 vaccines to people who are breastfeeding infants less than 9 months of age should be avoided due to the potential transfer of the live-attenuated vaccine virus through breastmilk. Younger infants (< 9 months of age) have a greater risk of developing yellow fever vaccine-associated neurotropic disease (YF-AND), a serious adverse event that can occur following yellow fever vaccination.
Individual advice should be sought from a travel/immunisation specialist if a breastfeeding person cannot avoid or delay travel to a yellow fever endemic area. If the benefits of vaccination outweigh the risks, then vaccination can be considered.
Access
Vaccines can be administered through local council immunisation services, accredited pharmacies, GP clinics and Aboriginal Health Services.
Influenza vaccines are not funded for breastfeeding people who do not have additional risk factors but can be privately purchased via their provider.
常见问题
Can people who are breastfeeding be in contact with someone who has recently been vaccinated?
Yes, it is safe for anyone breastfeeding to be around others who have recently been vaccinated (including those who have received a live-attenuated vaccine).
Can maternal antibodies in breastmilk interfere with a baby’s response to their own vaccines?
Antibodies transferred through breastmilk can impact an infant’s immune response to their own vaccines; however, this has been considered when determining infant vaccine recommendations.
Evidence from low- and middle-income countries shows that maternal rotavirus antibodies present in breastmilk contributed to a decrease in infant immune response to rotavirus vaccination. However, the resulting infant immune response was still adequate in protecting against disease.
Does maternal immunosuppression commenced whilst breastfeeding impact an infant’s vaccine schedule?
It is unlikely that maternal immunosuppressive medication, commenced whilst breastfeeding, will be transferred to an infant via breastmilk. These infants can be safely immunised according to the vaccines recommended on the NIP.
一个 exception to this is Rituiximab, with studies showing that maternal Rituximab has been found in breastmilk. The FDA recommends that breastfeeding be avoided for 6 months following receipt of this medication to prevent transmission to the infant.
Immunosuppressive medications are much more likely to cross the placenta. Therefore, when they are administered during pregnancy it is important to consider an infant’s vaccine schedule. For more information and guidance on infant vaccine recommendations when they are exposed to immunosuppressive medication in-utero, refer to MVEC: Immunosuppression in pregnancy and infant vaccine recommendations.
Can infants be breastfed when being vaccinated?
Yes. Offering a breastfeed to an infant at the time of their own vaccination can provide the infant with distraction and comfort during the procedure.
资源
作者： Nigel Crawford 博士（默多克儿童研究所 SAEFVIC 主任）、Rachael McGuire（MVEC 教育护士协调员）和 Georgina Lewis（默多克儿童研究所 SAEFVIC 临床经理）
审核人： Rachael McGuire (MVEC Education Nurse Coordinator), Katie Butler (MVEC Education Nurse Coordinator) and Nigel Crawford (Director, SAEFVIC and MVEC, Murdoch Children’s Research Institute)
日期： December 2024
本节内的材料将随着新信息的出现而进行更新。MVEC职员定期审阅材料的准确性.
You should not consider the information on this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.