Sophie’s choice – continue breastfeeding or protect myself from Covid-19?

There are few issues as divisive within the world of parenting as breastfeeding. Whatever your experience of it, it’s a charged subject. Statistics show that the majority of those who intend to have a baby, intend to breastfeed. According to Unicef, the last Infant Feeding survey was done in 2010 and, although those figures are 10 years old, there is little sign that they have changed much.

Breastfeeding initiation was 81% but by six weeks post-partum, only 24% of parents were still exclusively breastfeeding. At three months, that figure dropped to 17% and at 6 months, when most parents begin introducing solids, only 1% of babies are exclusively breastfed. 

According to Unicef “Breastfeeding rates in comparable European countries, with similar population sizes and demographics, show that it is possible to increase rates with a supportive breastfeeding culture and the political will to do so.”

https://www.unicef.org.uk/babyfriendly/about/breastfeeding-in-the-uk/

As someone who ran a campaign to “Keep Kent Breastfeeding” in 2017, I know how crucial good breastfeeding support truly is. I’ve had issues with all three of my children and relied heavily on the third sector for support to continue and troubleshoot the problems I had. My third child is three months old and it certainly doesn’t necessarily get any easier the more experience you have – if only because every breastfeeding relationship is different. 

The author, Tannice Hemming (second from right), with Hannah Croft IBCLC (far left) and Anna Le Grange IBCLC (far right) plus Kent breastfeeding mum, Caroline Mitford, in 2017.

The issues with breastfeeding aren’t helped by the fact that the information available to breastfeeding families – when it comes to the health of the lactating person – is so patchy, conflicting and confusing. So many times, parents are told to stop breastfeeding for their own health, when it’s unnecessary. 

One resource that’s really helpful but often not signposted to, is the Breastfeeding and Medication website, run by the wonderful pharmacist, Dr. Wendy Jones MBE. This has a wealth of information on which drugs are safe to take whilst breastfeeding and whether it’s safer to stop breastfeeding for some procedures (spoiler: it’s usually not). Having recently undergone a scan where contrast was used, I was lucky enough to be able to consult Wendy’s published advice and decide to continue breastfeeding, despite being told to temporarily “pump and dump”.  

http://breastfeeding-and-medication.co.uk

Sometimes the advice to temporarily stop breastfeeding is unlikely to cause much of a difficulty, where there is access to a pump and if your baby is already taking a bottle, as long as it’s not too long. That’s not to say that it’s good that parents are doing so unnecessarily, but it’s unlikely to completely sabotage the breastfeeding relationship too much.

However, there are cases where to advise the cessation of breastfeeding could sound the death knell for breastfeeding relationships – that very thing is happening now, since it is currently the advice to not have the Pfizer vaccination if you are breastfeeding. 

“Sophie’s choice” – my health – or breastfeeding?

Many healthcare professionals who are breastfeeding – or involved in breastfeeding education and support – are speaking out against this advice at present. Many are being more cautious as “we don’t currently know” how it would affect breastfed infants. 

Some parents, myself included, would rather be loose with the truth when it comes to taking the vaccine and decide to have it even though it’s officially recommended against. This is only a solution when that person considers themselves fairly educated on the topic and of course it means that any adverse effects in the lactating parent or breastfed infant will not be recorded. 

Based on what is already known about lactation, the ingress of medications into breastmilk and the way that the vaccinations work, the chances are that it’s extremely unlikely to be unsafe. Currently, the whooping cough vaccine, which is recommended in pregnancy, is not actually licensed for use to those carrying a child. Of course, since the Pfizer vaccine is so new, the medical authorities do not currently have the confidence to recommend that it is taken when pregnant or breastfeeding. 

In the USA, it is the American College of Obstetricians and Gynaecologists said, in a letter dated October 2020, they were “concerned that most, if not all, of the current Phase II/III vaccine trials exclude pregnant and lactating women, putting them at a disadvantage for protecting themselves against SARS-CoV-2.”

Their concern was for the workforce and they went on to state:

“Pregnant and lactating women make up a significant portion of the U.S. workforce, including roles critical to the pandemic response such as health care workers. Thus, it is critical that a vaccine allocation plan explicitly outline that pregnant and lactating women who otherwise fit the criteria for inclusion in a high-priority population can be vaccinated alongside their non-pregnant peers based on shared clinical decision making with the patient and her clinician.”

Protection by exclusion

Moreover, the Society for Maternal Fetal Medicine said, in a statement dated 1 December 2020, “Ultimately, the existing practice of “protection by exclusion” is harmful and has been characterized as clinical experimentation on pregnant women, as vaccines are distributed and administered without the safeguards of research protocols in place. Furthermore, there is no biological plausibility for the exclusion of lactating women from these trials.”

Breastfeeding the first of my two sons

The decision on when to wean has to be the second most controversial subject within infant feeding, as many women feel under pressure to do so due to societal (and even peer and family relationships). I have always wished to continue breastfeeding for as long as my child wished to, however difficult that has been. However this is my luxury due to being in a supportive relationship and with a “resting bitch face” when feeding that few bystanders are likely to pass comment on what I’m up to, lest they get a stream of invective. Not everyone is as confident however, so the idea that they’d be safer to stop breastfeeding to “be responsible” and get the vaccine is just absolutely heartbreaking. If it’s the choice between living a life as close to normal in a post-Coronavirus world plus keeping vulnerable friends and family safe or continuing to breastfeed when formula is readily available and totally normalised, there really wouldn’t seem to be much of a choice. 

Lobbying for change

This is why I’m calling on all those who care about breastfeeding to join me in lobbying their MPs to encourage the government to seek further advice on giving the vaccine to anyone who is breastfeeding. Let’s also look to make it easier for women to access medicine without an automatic directive to stop breastfeeding. Let’s recognise how important it is to breastfeeding families and their children to continue the breastfeeding relationship and encourage healthcare professionals to consult places like the Hospital Infant Feeding Network, https://www.hifn.org/about, Breastfeeding and Medication, the GP Infant Feeding Network https://gpifn.org.uk and other resources designed to help preserve the breastfeeding relationship whenever possible. 

Write to your MP and sign the petition

After my youngest’s tongue tie was cut

If you feel strongly about this, please go to https://www.writetothem.com and find your MP. Tell them how important it is that our healthcare and front line workers who are breastfeeding are supported to keep feeding and can access the vaccine, should they wish to. Let’s put pressure on the government to ask the MHRA to think again and consult more widely with lactation experts on whether they can look to include lactating parents in the list of those who are safe to feed. 

You can also sign my petition at https://www.change.org/bf-and-covid-vaccine to add your name to the small but growing list of people who feel the same as me.

We simply shouldn’t be making people like me, feeding their precious children, choose between providing nutrition for their offspring and their own safety, let alone the safety of wider society. 

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