Maternal, Infant, and Breast Milk Antibody Response Following COVID-19 Infection in Early Versus Late Gestation

Wachman, Elisha M.; Snyder‐Cappione, Jennifer; Devera, Jean; Boateng, Jeffery; Dhole, Yashoda; Clarke, Katherine; Yuen, Rachel; Parker, Samantha E.; Hunnewell, Jessica; Ferraro, Renee; Jean-Sicard, Sigride; Woodard, Elizabeth; Cruikshank, Alice; Sinha, Bharati; Bartolome, Ruby; Barnett, Elizabeth D.; Yarrington, Christina; Taglauer, Elizabeth; Sabharwal, Vishakha

doi:10.1097/inf.0000000000003802

Cited by 10 publications

(12 citation statements)

References 40 publications

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“…A total of 82 studies were finally included ( 4 , 6 , 9 – 88 ), including three studies published in Chinese ( 25 , 27 , 28 ). They came from 21 countries, with 26 studies from China (31.7%).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-nine studies reported results of antibody testing against SARS-CoV-2 in at least 1,279 breast milk samples from mothers with a confirmed diagnosis of COVID-19 ( 9 , 10 , 62 – 88 ), and the majority of mothers included in these studies had mild disease severity. All 29 studies showed the presence of at least one of the three antibodies, IgA, IgG and IgM, in breast milk.…”

Section: Resultsmentioning

confidence: 99%

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Breastfeeding vs. breast milk transmission during COVID-19 pandemic, which is more important?

He,

Liu,

et al. 2023

Front. Pediatr.

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The catastrophic coronavirus disease 2019 (COVID-19) pandemic has raised many health questions, and whether breast milk from SARS-CoV-2 infected mothers may be a vector for SARS-CoV-2 transmission has become a hot topic of concern worldwide. Currently, there are extremely limited and conflicting data on the risk of infection in infants through breastfeeding. For this reason, we investigated almost all current clinical studies and systematically analyzed the presence of SARS-CoV-2 and antibodies in the breast milk of mothers infected with SARS-CoV-2, their effects on newborns, and the mechanisms involved. A total of 82 studies were included in this review, of which 66 examined the presence of SARS-CoV-2 in breast milk samples from mothers diagnosed with COVID-19, 29 reported results of antibody detection of SARS-CoV-2 in breast milk, and 13 reported both nucleic acid and antibody test results. Seventeen studies indicated the presence of detectable SARS-CoV-2 nucleic acid in breast milk samples, and only two studies monitored viral activity, both of which reported that infectious viruses could not be cultured from RNA-positive breast milk samples. All 29 studies indicated the presence of at least one of the three antibodies, IgA, IgG and IgM, in breast milk. Five studies indicated the presence of at least one antibody in the serum of breastfed newborns. No COVID-19-related deaths were reported in all 1,346 newborns. Our study suggests that direct breastfeeding does not pose an additional risk of infection to newborns and that breast milk is a beneficial source of anti-SARS-CoV-2 antibodies that provide passive immune protection to infants. In addition, direct breastfeeding would provide maternal benefits. Our review supports the recommendation to encourage direct breastfeeding under appropriate infection control guidelines.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier: 458043.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Breastfeeding vs. breast milk transmission during COVID-19 pandemic, which is more important?

He,

Liu,

et al. 2023

Front. Pediatr.

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“…Such concepts of protection have been reasonably well-established for many coronaviruses, especially in the veterinary field [ 156 ]. In parallel to the latter, breast milk anti-SARS-CoV-2 antibody declines in the first year [ 157 ]. In keeping with past experience from other respiratory virus infections, there is a strong correlation between increased circulating maternal antibody levels, increased quantities of circulating infant antibody levels, and increased breast milk antibody levels [ 157 ].…”

Section: Controversy Regarding Infantsmentioning

confidence: 99%

“…In parallel to the latter, breast milk anti-SARS-CoV-2 antibody declines in the first year [ 157 ]. In keeping with past experience from other respiratory virus infections, there is a strong correlation between increased circulating maternal antibody levels, increased quantities of circulating infant antibody levels, and increased breast milk antibody levels [ 157 ]. The move to protect mothers from serious disease and protect their infants via the latter through vaccination was justified on theoretical grounds early but then corroborated specifically for COVID-19.…”

Section: Controversy Regarding Infantsmentioning

confidence: 99%

COVID-19 among infants: key clinical features and remaining controversies

Cimolai

2024

Clin Exp Pediatr

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Infants aged <1 year represent a seemingly more susceptible pediatric subset for infections. Despite this, coronavirus disease 2019 (COVID-19) infection has not been proven as more serious in this age group (outside the very early neonatal period) than in others. Indeed, a considerable number of asymptomatic infections have been recorded, and the symptoms and morbidity associated with COVID- 19 differ minimally from those of other respiratory viral infections. Whether due to an abundance of caution or truly reduced susceptibility, infections in infants have not raised the same profile as those in other age groups. In addition to direct severe acute respiratory syndrome coronavirus 2 diagnostic tests, laboratory markers that differentiate COVID-19 from other viral infections lack specificity in infants. Gastrointestinal presentations are common, and the neurological complications of infection mirror those of other respiratory viral infections. There have been relatively few reports of infant deaths. Under appropriate precautions, breastfeeding in the context of maternal infections has been associated with tangible but infrequent complications. Vaccination during pregnancy provides protection against infection in infants, at least in the early months of life. Multi-inflammatory syndrome in children and multi-inflammatory syndrome in neonates are commonly cited as variants of COVID-19; however, their clinical definitions remain controversial. Similarly, reliable definitions of long COVID in the infant group are controversial. This narrative review examines the key clinical and laboratory features of COVID-19 in infants and identifies several areas of science awaiting further clarification.

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“…The study by Szcygiol and colleagues confirms the presence of SARS-CoV-2 IgA and IgG antibodies in the breastmilk of SARS-CoV-2--recovered women and found no relation of the antibody levels and the trimester of infection. The study, although including all three trimesters, does not elaborate on their specific findings in relation to the trimester of infection, and only collected breastmilk samples at one timepoint [ 7 , 8 , 9 ]. Based on the findings of Fich et al and the lack of representation of all three trimesters in the literature, we hypothesize that the timing of infection in naturally immunized mothers could have a possible impact on future SARS-CoV-2 maternal–neonate immunization.…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 Antibodies in Breastmilk Three and Six Months Postpartum in Relation to the Trimester of Maternal SARS-CoV-2 Infection—An Exploratory Study

Fich,

Christiansen,

Nilsson

et al. 2024

IJMS

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The immune system of neonates is immature and therefore knowledge of possible early-life protection against SARS-CoV-2 infection, such as breastfeeding, is of great importance. Few studies have investigated the presence and duration of SARS-CoV-2 antibodies in breastmilk in relation to the trimester of maternal infection during pregnancy, and none with successful participation from all three trimesters. This study has dual objectives (1) in relation to the trimester of infection to examine the frequency, concentration and duration of IgA and IgG antibodies in breastmilk and blood serum in the third and sixth month post-partum in former SARS-CoV-2-infected mothers and (2) to examine the association in pediatric emergency admission of children within the first six months of life compared to children of non-SARS-CoV-2-infected women. The first objective is based on a prospective cohort and the second is based on a nested case–control design. The study participants are women with a former SARS-CoV-2 infection during pregnancy, whose serology IgG tests at delivery were still positive. Maternal blood and breastmilk samples were collected at three and six months postpartum. Serum IgA frequency three months pp was 72.7% (50%, 90% and 60% in the first, second and third trimester) and 82% six months pp (67%, 91% and 82% in the first, second and third trimester). Breastmilk IgA frequency three months pp was 27% (16.6%, 36% and 20% in first, second and third trimester) and 28% six months pp (0%, 38% and 28% in the first, second and third trimester). The highest IgA concentration in breastmilk was found six months post-partum with infection in the third trimester. Serum IgA was detectable more than 400 days post infection, and serum IgG above threshold was found 430 days after date of infection. We found no correlation between serum IgA and breastmilk IgA, nor between serum IgG and breastmilk IgA regardless of the trimester of infection.

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Maternal, Infant, and Breast Milk Antibody Response Following COVID-19 Infection in Early Versus Late Gestation

Cited by 10 publications

References 40 publications

Breastfeeding vs. breast milk transmission during COVID-19 pandemic, which is more important?

Breastfeeding vs. breast milk transmission during COVID-19 pandemic, which is more important?

COVID-19 among infants: key clinical features and remaining controversies

SARS-CoV-2 Antibodies in Breastmilk Three and Six Months Postpartum in Relation to the Trimester of Maternal SARS-CoV-2 Infection—An Exploratory Study

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