Attribution Statement: LactMed is a registered trademark of the U.S. Department of Health and Human Services.
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-.
Drug Levels and Effects
Summary of Use during Lactation
The Centers for Disease Control and Prevention and several health professional organizations state that vaccines given to a nursing mother do not affect the safety of breastfeeding for mothers or infants and that breastfeeding is not a contraindication to cholera vaccine. Breastfed infants should be vaccinated according to the routine recommended schedules.[1-3]
Drug Levels
Maternal Levels. Relevant published information was not found as of the revision date.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
Limited data indicate that breastfeeding can enhance the response of the infant to certain vaccine antigens.[1,2,4]
Administration of injectable cholera vaccine increases milk secretory IgA antibodies against cholera in the breastmilk in some reports.[5,6] Oral cholera vaccines result in a much lower increase in breastmilk anticholera antibodies.[7,8] However administration of oral cholera vaccine to the mother decreased the risk of cholera in their breastfed infants by 47% in one study. The authors hypothesized that vaccination of the mothers reduced their transmission of cholera to their infants.[7]
An open-label study in Bangladesh compared the serum immune response to administration of an oral cholera vaccine (Dukoral; containing killed cholera organisms and cholera subunit B) found that withholding breastfeeding for 3 hours before giving the vaccine resulted in a greater antibody response in infants between 10 and 18 months of age. In infants between 6 and 9 months of age, no difference in antibody response was seen between infants who had breastfeeding withheld and those who did not.[9]
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
References
- 1.
- Ezeanolue E, Harriman K, Hunter P, et al. Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP). https://www
.cdc.gov/vaccines /hcp/acip-recs /general-recs/index.html Accessed June 5, 2020. - 2.
- Kimberlin DW, Brady MT, Jackson MA, et al. Red Book: 2018 Report of the Committee on Infectious Diseases. 31st ed. Elk Grove Village, IL: American Academy of Pediatrics. 2018.
- 3.
- Gruslin A, Steben M, Halperin S, et al. Immunization in pregnancy: No. 220, December 2008. Int J Gynaecol Obstet. 2009;105:187–91. [PubMed: 19367691]
- 4.
- Pabst HF. Immunomodulation by breast-feeding. Pediatr Infect Dis J. 1997;16:991–5. [PubMed: 9380478]
- 5.
- Merson MH, Black RE, Sack DA, et al. Maternal cholera immunisation and scecretory IgA in breast milk. Lancet. 1980;1:931–2. [PubMed: 6103281]
- 6.
- Svennerholm AM, Holmgren J, Hanson LA, et al. Boosting of secretory IgA antibody responses in man by parenteral cholera vaccination. Scand J Immunol. 1977;6:1345–9. [PubMed: 605366]
- 7.
- Clemens JD, Sack DA, Chakraborty J, et al. Field trial of oral cholera vaccines in Bangladesh: evaluation of anti-bacterial and anti-toxic breast-milk immunity in response to ingestion of the vaccines. Vaccine. 1990;8:469–72. [PubMed: 2251873]
- 8.
- Jertborn M, Svennerholm AM, Holmgren J. Saliva, breast milk, and serum antibody responses as indirect measures of intestinal immunity after oral cholera vaccination or natural disease. J Clin Microbiol. 1986;24:203–9. [PMC free article: PMC268875] [PubMed: 3528211]
- 9.
- Ahmed T, Svennerholm AM, Al Tarique A, et al. Enhanced immunogenicity of an oral inactivated cholera vaccine in infants in Bangladesh obtained by zinc supplementation and by temporary withholding breast-feeding. Vaccine. 2009;27:1433–9. [PubMed: 19146904]
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
- User and Medical Advice Disclaimer
- Drugs and Lactation Database (LactMed) - Record Format
- LactMed - Database Creation and Peer Review Process
- Fact Sheet. Drugs and Lactation Database (LactMed)
- Drugs and Lactation Database (LactMed) - Glossary
- LactMed Selected References
- Drugs and Lactation Database (LactMed) - About Dietary Supplements
- Breastfeeding Links
- Review Vaxchora: A Single-Dose Oral Cholera Vaccine.[Ann Pharmacother. 2017]Review Vaxchora: A Single-Dose Oral Cholera Vaccine.Cabrera A, Lepage JE, Sullivan KM, Seed SM. Ann Pharmacother. 2017 Jul; 51(7):584-589. Epub 2017 Mar 8.
- Review BCG Vaccine.[Drugs and Lactation Database (...]Review BCG Vaccine.. Drugs and Lactation Database (LactMed®). 2006
- Review Rabies Vaccine.[Drugs and Lactation Database (...]Review Rabies Vaccine.. Drugs and Lactation Database (LactMed®). 2006
- Review Anthrax Vaccine.[Drugs and Lactation Database (...]Review Anthrax Vaccine.. Drugs and Lactation Database (LactMed®). 2006
- Review Varicella Vaccine.[Drugs and Lactation Database (...]Review Varicella Vaccine.. Drugs and Lactation Database (LactMed®). 2006
- Cholera Vaccine - Drugs and Lactation Database (LactMed®)Cholera Vaccine - Drugs and Lactation Database (LactMed®)
Your browsing activity is empty.
Activity recording is turned off.
See more...