What new mothers need to know about COVID-19 vaccination

Pregnancy and the period of breastfeeding are a test of strength for the female body. In order to bear a baby, the expectant mother's immunity levels decrease, so she becomes vulnerable to infections. A similar situation occurs after childbirth. Are there safe antiviral drugs that nursing mothers can take?

The importance of breastfeeding (BF)

The text of the joint WHO and UNICEF Global Strategy on Infant and Young Child Feeding states: “Breastfeeding is the best way to provide ideal nutrition for the healthy growth and development of children.” Both pediatricians and mothers themselves agree with this statement.

Breast milk has a complex chemical composition and few people do not know that its biological value for a child is superior to all other products found in nature. Human milk contains more than 30 fatty acids, 20 amino acids, about 40 different minerals, 17 vitamins, specific growth factors, dozens of enzymes, various carbohydrates, hormones, prostaglandins and a complex of factors with anti-inflammatory activity. Breastfeeding is the best thing a woman can give to her child.

Too early

Breastfeeding is a very short stage in a child’s life.
It would be ideal to feed the baby until the age when his need for latching subsides on its own. The age at which a child himself, without mother’s help and serious efforts on her part, is ready to give up breastfeeding usually occurs after three years. The mother’s body is ready to complete lactation earlier - already at 1.5-2 years of age. Completion of lactation at an earlier stage is not physiological and, as a rule, is associated with errors and diseases:

• rare feedings,
• adding water,
• early complementary feeding,
• cracked nipples,
• lactostases,
• mastitis and, as a consequence, lack of milk and underweight of the child,
• or problems with the mother's health.

Weaning before 1 -1.5 years is possible, both planned and emergency, and for this, as a rule, there are good reasons: hospitalization of the mother, the need to take medications incompatible with feeding the child, family situations requiring the mother’s departure, and others unseen circumstances.

Use of medications during breastfeeding

It happens that during lactation a woman gets sick. And she needs to choose medications that would help fight the disease and not harm the child. It should be borne in mind that a wide range of antiviral drugs are absolutely not suitable for treating a nursing woman.

After all, not only useful substances are transmitted with mother’s milk, but also medications that a woman takes, and as you know, not all drugs are suitable for babies. There are also medications that can reduce milk production or stop it altogether. Therefore, when prescribing drugs, the risk for the baby and the benefit for the mother are always taken into account.

The degree of adverse effect of the drug on the infant’s body is determined by the following factors:

• toxicity of the drug;
• the true amount of the drug entering the child’s body (it depends on the dose, concentration of the drug in breast milk and on the amount of milk consumed by the child);
• the peculiarity of the drug’s effect on the child’s internal organs;
• the duration of removal of the medicine from the child’s body (this depends on the maturity of the enzyme systems, the maturation of the baby’s liver and kidney function);
• duration of medication taken by a nursing mother;
• the child’s individual sensitivity to this drug;
• risk of developing allergic reactions.

NEW LEVEL

In autumn and at the end of winter and beginning of spring, the incidence of influenza usually increases: the risk of developing epidemics is maximum at temperatures from -5 to +5, due to the combination of cooled (but not frosty) air and dry airways. Influenza is one of many respiratory viruses that affects the nose, throat and lungs; but it differs in that its consequences and complications can be very severe, and small children and pregnant women are at risk, so many expectant and nursing mothers are very concerned about the likelihood of getting the flu for themselves and their baby. We will try to answer the most common questions about the flu and breastfeeding.

Is the flu transmitted through breast milk? No, breast milk does not transmit the influenza virus. Transmission of the influenza virus occurs only through the respiratory route: microdroplets containing the virus spread from person to person when coughing or sneezing; Infection is also likely if you touch a surface on which microdroplets with the virus have settled, and then touch your nose, mouth or eyes.

Can the disease somehow affect lactation? Yes, it is possible that against the background of elevated temperature and general weakness of the body, milk production will decrease. This is a temporary decrease; as health improves, lactation will increase again, provided the mother continued to breastfeed or at least express milk.

Is it necessary to interrupt breastfeeding if the mother is already sick but the baby is not? No, there is no need to interrupt it, and it is highly advisable to continue feeding! Breast milk contains influenza antibodies and immune factors that reduce the likelihood of a baby developing the flu. And even if the mother feels too sick to breastfeed, and at the same time one of the healthy family members can take care of the baby, milk must be expressed, first of all, to avoid the risk of developing mastitis due to stagnation of milk against the background of general weakness of the body. Before pumping, you need to wash your hands very well with soap and water, and make sure that the pumping equipment has been sterilized. Expressed milk can and should be given to your baby! But in principle, it is usually easier for a mother if she has the opportunity, even if she is lying in bed with an illness, to simply put the baby to her breast for feeding, so that later healthier family members can take him for constant care.

What if the child is sick, but the mother is not yet? This is an extremely rare scenario; usually, on the contrary, when a nursing mother and baby are simultaneously infected, the child either does not develop the disease at all, or develops later and passes in a milder form due to the support of numerous protective factors of breast milk. But if it does happen that the baby gets sick before the mother, again, it is very advisable to continue breastfeeding, because this helps stabilize the child’s condition, avoid the risks of dehydration, and contact with the mother reduces stress (which in turn can increase inflammation) . A sick child usually feels unwell both physically and mentally; lack of contact with his mother through breastfeeding can worsen his condition.

What can you do to reduce your risk of getting the flu? Ways to reduce the risk of getting sick are well known to everyone:

- stay at least a meter away from people with flu-like symptoms - coughing and sneezing;

— avoid crowds of people;

- wash your hands regularly and thoroughly with soap and water, avoid touching your nose, mouth and eyes;

- if there is a person with the flu in the house, ventilate the premises well and do wet cleaning;

- if the nursing mother herself is already sick - cover her face with a paper napkin or cloth when coughing and sneezing, removing them immediately after coughing and sneezing, and wash your hands well every time after contact with respiratory secretions and before contact with the baby. If there are no handkerchiefs or napkins nearby when you sneeze or cough, it is recommended to shield your face as much as possible with your arm bent at the elbow.

Should a nursing mother suffering from the flu wear a medical mask when in contact with her baby? Using a mask continuously for a long time is not recommended; on the contrary, it can contribute to the development of the disease due to difficulty breathing and the accumulation of respiratory secretions on the mask. When sick, it is advisable to use paper napkins or cloth handkerchiefs, which, when dirty, are thrown away or treated well, respectively. The mask is recommended for wearing, on the contrary, by a healthy person when in contact with a sick or possibly sick person, and wearing the mask should be relatively short-term, or, for long-term contact, the mask should be changed from time to time for a new one; when worn, the mask should cover the mouth and nose well, leaving no gaps; if it becomes damp, it must be immediately replaced with a new, dry one; When replacing or removing a mask, the old one is immediately thrown away.

From the point of view of reducing the likelihood of the spread of influenza, if the mother is already sick and the child is not, the most optimal thing is for one of the healthy family members to take care of the child, who, when in contact with the sick, himself wearing a mask, would bring time from the child’s time (without a mask!) for feeding to a mother who tries to hold back coughing or sneezing during feeding, or actively uses handkerchiefs and paper napkins that are constantly refreshed; and after feeding he would wash the baby and take him to a well-ventilated room.

Is hospitalization necessary if a nursing mother is infected with influenza? In most cases, no - most often the flu goes away safely if you provide rest, plenty of fluids and the opportunity to rest and eat fully according to your appetite. If necessary, painkillers are also taken (attention, due to the risk of developing Reye's syndrome, it is NOT recommended to take painkillers containing aspirin!) But in some cases, when the body of the mother or baby is weakened, extremely severe complications are likely. You should definitely seek medical help if:

- with the flu, the mother or baby has difficulty breathing, shortness of breath;

- elevated temperature persists for more than three days;

— An urgent visit to a doctor is necessary if the baby develops convulsions against the background of an elevated temperature!

If mother, baby, or both are hospitalized due to complications from influenza, it is generally advisable to continue breastfeeding while they are together and, if separated, to pass on expressed milk to the baby (remembering to thoroughly wash hands and sterilize all pumping equipment ). Breast milk is still a very important factor in accelerating the baby’s recovery.

What is the relationship between the flu vaccine and hepatitis B? Influenza vaccination is not contraindicated during lactation. There is an opinion that if a nursing mother is vaccinated against the flu, then through breast milk she shares the accumulated immune bodies with the child. Influenza vaccination is not recommended for children under six months of age, but if the flu vaccine is given to a child older than six months, then there are no negative effects on breastfeeding; breastfeeding can be done immediately after vaccination or even during the vaccination process to reduce pain.

How does taking anti-influenza drugs affect milk? Specialized anti-influenza medications should usually NOT be used for prevention and should only be started when prescribed by a doctor. For nursing mothers, oseltamivir (Tamiflu) is currently considered the most preferred drug; it passes into milk in very small quantities, and no unpleasant effects have been reported in children when taken by nursing mothers. Also, from the range of modern antiviral drugs to combat influenza, zanamivir (Relenza) is considered safe for lactation.

We wish you a speedy recovery without compromising the health of yourself and your babies!

Prepared by Irina Ryukhova, sources of information:

https://www.cdc.gov/breastfeeding/disease/influenza.htm

https://www.who.int/csr/disease/swineflu/frequently_asked_questions/what/ru/

https://www.who.int/csr/resources/publications/swineflu/masks_community/ru/

Go to other interesting articles on breastfeeding for mothers

Our useful and interesting webinars for nursing mothers

What to do if a mother has a fever while breastfeeding

Experts say that most medications are not suitable for use during lactation. It must be remembered that a nursing mother can take any medications, including antipyretics, only as prescribed by a doctor. The use of antipyretic drugs is advisable only when the temperature rises above 38 0C. Lower temperatures are an adequate response of the body to the virus and do not require medical intervention.

If the temperature rises and a nursing mother needs help in the form of taking medications, it is recommended to take antipyretics, which include ibuprofen and paracetamol, during breastfeeding.

Medicines for lactation

Young mothers are allowed to use the following medications:

1. Antipyretics - help in the fight against high fever, relieve headaches. Products containing Paracetamol are allowed.
2. Antiviral and immunomodulatory drugs effectively act on the cause of the pathology and help strengthen the body’s protective function.
3. Saline remedies for nasal debt in the form of a solution.

Any drug has absolute contraindications. This should also be taken into account during the treatment process.

How to treat allergies during lactation

An allergic reaction during lactation is a fairly common occurrence. To prevent and combat allergies, a nursing woman should follow these rules:

• Ventilate your living space daily and do wet cleaning.
• Avoid eating the following foods: citrus fruits, chocolate, fish, honey, nuts, take a test to determine your tolerance to certain foods.
• Clean carpets, curtains and stuffed animals from dust and mites frequently.
• Wash bedding sets regularly, and the water temperature should be at least 60 0C
• During the warm season, do not walk in places where there are many flowering trees.
• When traveling by car, do not open the windows.

Antihistamines can only be prescribed to nursing women by a doctor, taking into account all contraindications.

Are there any contraindications

Whether or not a nursing mother can be vaccinated is decided by the doctor after an examination. Given the weakened state of the immune system, a person with obvious cold symptoms, or if less than 14 days have passed since recovery, is not allowed to get vaccinated. Absolute contraindications to vaccination for hepatitis B (and not only) are also:

• chronic kidney and liver diseases;
• diabetes;
• diseases of the cardiovascular or respiratory systems;
• anemia;
• disruption of the nervous system;
• manifestation of allergies to chicken protein, medications.

Flu vaccination is not carried out even in cases where a person has previously experienced severe side effects from it. Attention is also paid to the temperature - even if it is constantly elevated, no vaccination is given.

In addition to the presence of the listed diseases and allergies, the doctor assesses the general condition of the patient. If it does not cause concern and there are no contraindications, the therapist gives a referral for vaccination.

What antiviral drugs can nursing mothers take for colds and coughs?

Treating cold and flu symptoms while breastfeeding

Women during lactation, in consultation with their doctor, are allowed drugs containing naphazoline nitrate, which help temporarily relieve swelling of the nasal mucosa. These drugs have a short period of action.

Sometimes drugs containing xylometazoline are recommended, which have an average duration of anti-edematous action and are also intended to relieve swelling, hyperemia of the nasal mucosa, restore patency of the nasal passages and facilitate nasal breathing.

Preparations containing oxymetazoline have the longest duration of active action - when administered intranasally, they reduce swelling of the mucous membrane of the upper respiratory tract for 10-12 hours.

To reduce cough, expectorants are prescribed to thin the mucus, which allows you to cleanse the bronchi and restore their functions.

Herbal preparations based on:

• licorice root;
• anise;
• ivy;
• thyme;
• thyme;
• plantain and other plant components that promote the removal of mucus from the bronchi.

For a runny nose, oil drops in the nose are additionally used, which have an anti-inflammatory and antimicrobial effect, and sprays to moisturize the nasal mucosa, which are made on the basis of sea water. These drugs thin out mucus, improving its discharge, and help normalize the functioning of the nasal mucosa.

For a sore throat, it is possible to use local antiseptic (antimicrobial) drugs, gargle solutions and lozenges. An aqueous solution of potassium iodine is used to lubricate the pharyngeal mucosa.

Contraindications

Drugs whose main active ingredient is bromhexine are contraindicated for lactating and pregnant women.

Treatment of the virus with antiviral drugs for hepatitis B

But all these drugs only temporarily relieve unpleasant symptoms. To combat various viruses, including the influenza virus, it is necessary to use antiviral drugs approved for use during lactation. One of these drugs is VIFERON. This drug is available in the form of suppositories, ointment or gel. He carefully takes care of women’s health and allows them not to interrupt the feeding of the child during the course of treatment. It is advisable to start using suppositories when the first signs of the disease appear, but at a later date their use will be justified. Lactation is also not a contraindication for the use of VIFERON Gel/Ointment; you just need to remember that they cannot be applied to the nipple area during feeding. VIFERON can also be used in combination with other medications recommended by your doctor.

Traditional methods

Effective home remedies against the flu for women with breastfeeding are:

1. Gargling for inflammation and pain with a solution of soda and salt. To prepare the product, take half a teaspoon of soda and salt and dilute it in a glass of water. The procedure is carried out every 4 hours.
2. Taking cranberry juice strengthens the immune system and fights infection well.
3. Milk with honey. Also an excellent remedy for a sore throat. Helps relieve inflammation and improves sleep.
4. Viburnum decoction. Effective against fever and fighting infectious agents. Use fresh fruits and jam.

Such folk recipes not only have a pronounced therapeutic effect, they also help in the prevention of viral infections and are useful for health.

Instructions for use of Viferon gel, suppositories and ointment for nursing mothers

Scheme for using the antiviral drug VIFERON Gel during breastfeeding

Scheme for using the antiviral drug VIFERON Ointment during breastfeeding

Scheme of use of the antiviral drug VIFERON Suppositories (rectal suppositories) for nursing mothers

Author of the article

Belyaev Dmitry Alexandrovich

General doctor

Reference and information material

Loading...

Take other surveys

Features of vaccination of pregnant women

In most cases, vaccination is carried out in a clinic. But if desired, vaccination can be given in other institutions where there is a special room and permission to carry out vaccination. The causes of frequent colds in adults are described in the article.

The flu vaccine contains proteins to which the immune system produces antibodies. This takes two to three weeks, after which we can say with confidence that the person is protected from the disease for six to eight months. Pregnant women are a special group for which almost all drugs used for treatment and vaccinations are prohibited, since their consequences for the health of the unborn baby are unknown.

Many vaccine instructions state that vaccination can be done during pregnancy, but only if the benefit outweighs the possible harm. The difficulty is that the drugs are not tested on pregnant women. The main contraindications to vaccination are described at the link.

You can get a flu shot during pregnancy, but you should only choose a high-quality inactivated vaccine.

Vaccination is carried out in the second or third trimester of pregnancy. Usually, vaccinations are given in October and November, but if this period falls during the first trimester, then it is necessary to assess the possible risks for both the mother and the unborn child.