ABM President responds to Vaccines and Breastfeeding

In response to confusion and misinformation regarding the recent report of:

Moon et al (Ped Inf Dis J 2010 29;919 ) entitled:
“Inhibitory effect of breast milk on infectivity of live oral rotavirus vaccines”

the following clarification is provided:

1. The study related only to oral rota virus vaccine and DOES not provide information on any other oral vaccine ( such oral polio) and surely has no relevance to standard non oral vaccines

2. The study of the neutralizing effect of breast milk was an IN VITRO study and the significant neutralizing effect was only found in milk from mothers from developing countries(Vietnam, South Korea, India) AND NOT from milk from US mothers. This reflects probably the high frequency of rotavirus infection in those countries and the high antibody levels in the adults of those countries and the low titers in US mothers.

3. Epidemiological studies have noted adequate efficacy of oral rotavirus vaccine in industrialized countries …the only issue is the somewhat lower efficacy in the developing countries

4. Oral polio vaccine is not the standard in North America so is not a relevant issue

5. At most the investigators recommend “evaluating” (STUDYING) the effect of delaying breastfeeding at the time of immunization (of rota virus ) and measuring the efficacy ( serum antibodies in the infants). “Delaying” means not breastfeeding simultaneously when ingesting the vaccine and delaying nursing for 2-3 hours. NO suggestion of substituting formula was made or should be made !

6. Bottom line: the study has absolutely NO relevance to nursing mothers in industrialized countries ( surely NOT the US and Canada) and therefore NO change in the routines of breastfeeding infants who are being vaccinated are being suggested! (and so spread the word!)

7. The possible benefit of a few hours wait between oral rota virus vaccination and nursing should be studied in populations in those geographic areas where there is a problem of efficacy. As there may be other factors effecting efficacy (e.g. related to the immunocompetence of the infants themselves) until we have the results of such IN VIVO studies one can not make any feeding recommendations even for those populations. The problem may not relate to breast milk at all! That why evidenced based data is needed!

8. For the nursing mother in the developed world there is no need to alter any feeding routines!

Arthur I Eidelman MD FAAP FABM

Arthur Eidelman is a neonatologist and president of the Academy of Breastfeeding Medicine.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.