On Only The Breast, a website devoted to the buying and selling of breast milk, one ad advertises “COVID antibody” milk at $2 an ounce. Another says the donor has been vaccinated with Pfizer’s COVID-19 vaccine and offers milk at $2.50 an ounce: “Provide your baby with safe antibodies!” it reads. A third listing offers milk for free and notes, “I received the full course of Pfizer’s covid vaccination, so it’s possible that there may be some added benefit transmitted.”
These are just a sampling of pages of ads on the site offering breast milk that reportedly contains COVID-19 antibodies. One seller, 33-year-old Tara in South Dakota, was already selling milk but decided to add that she had COVID-19 antibodies to attract buyers.
“I am willing to share if it’s going to, you know, make a mom feel better about her baby,” says Tara, who asked that only her first name be used for privacy reasons. “I know there’s not a ton of information about it in breast milk or, necessarily, how long between feedings the antibodies lasts or anything like that – but even if it’s for peace of mind.”
Photos: America’s Pandemic Toll
Information on the impact of COVID-19 vaccines in pregnant or breastfeeding people has been scant until recently. Pregnant people weren’t included in initial clinical trials for the vaccines, but emerging data and research focused on the Pfizer and Moderna mRNA shots have indicated they are safe during pregnancy and can have a potentially positive impact on babies.
For example, a study published in late March by the American Journal of Obstetrics and Gynecology found evidence that the COVID-19 mRNA vaccines generated a robust immunity response in pregnant and lactating women, and that antibodies were transferred via the placenta and breast milk.
And though additional data is still needed – including on how long protection transferred to a breastfed infant may last – one study from Washington University in St. Louis found a “potential immune benefit” for infants up to 80 days post-vaccination. Another study out of Israel found “robust secretion” of coronavirus-specific antibodies in breast milk for six weeks after vaccination, with significant antibody elevation two weeks following the first dose, on average. Both studies focused on parents who’d received the Pfizer vaccine.
Experts also told The New York Times that breast milk offers short-term, “passive protection” akin to taking a pill each day.
“Antibodies found in breast milk of these women showed strong neutralizing effects, suggesting a potential protective effect against infection in the infant,” authors of the Israel study said.
Such information may be helping to fuel efforts by vaccinated moms to sell their breast milk, as well as interest among others in obtaining the antibodies within breast milk before a vaccine is approved for use in children.
For her part, Tara says she had read about mothers who resumed pumping again after they had been vaccinated. Indeed, the Times earlier this month pointed to online forums where moms talked about relactating post-vaccination. A New York Magazine article in late March also noted the interest in breast milk with antibodies, and referenced parents giving chocolate breast milk to a toddler or slipping breast milk into older children’s scrambled eggs, hoping to prompt immunity.
Rachel, a Maryland mother who has been selling her breast milk in tandem with the births of three of her four children, says she has about two months’ worth of milk frozen since she got her vaccine. With her second child, she says, “I realized that you can actually make pretty good money selling it, so I figured, ‘Why not?’ Day care is really expensive.”
The 36-year-old, who also asked to go by her first name for privacy reasons, says she asked her oldest child, a 7-year-old, if he would like some of her breast milk. He said no. Her husband, however, accepted a few smoothies with breast milk in it until he could get his vaccine, she says.
Notably, the Food and Drug Administration recommends against feeding a baby breast milk acquired directly from an individual or via the Internet, although it remains unregulated.
Dr. Lisa Stellwagen, a clinical professor of pediatrics in the University of California-San Diego School of Medicine and member of the American Academy of Pediatrics section on breastfeeding, says milk bought online may have high rates of bacterial contamination and been stored in suboptimal conditions during shipping. A 2013 study found “high levels of overall bacterial growth and frequent contamination with pathogenic bacteria” in breast milk samples bought through the Internet.
Only The Breast notes on its website that studies have shown unpasteurized milk may contain bacteria, and states in all caps that all milk must be pasteurized before use.
Stellwagen also notes it’s possible other things could be transmitted via breast milk, including HIV. “So the idea of using raw milk from a mother who hasn’t been tested is a high-risk situation from that basis,” she says.
Stellwagen is also executive director of the University of California Health Milk Bank. She says people looking to donate milk to the bank are given a robust questionnaire that covers any potential exposures to disease they’ve had and contains multiple lifestyle questions. Only about a third of women tend to make it through the process, she says.
And while online sales of breast milk mean a person could buy milk with antibodies produced by just one person, milk banks work differently: Donor milk is pooled together, which Stellwagen says is to increase calorie composition. The milk is also pasteurized, which will kill harmful bacteria but not antibodies, Stellwagen says.
The pooling process means it’s unlikely that a mix containing breast milk from people who’ve gotten a COVID-19 vaccine and from others who haven’t will produce any significant immune protection, Stellwagen says.
More broadly, though, there’s a key question: Can ingesting non-pooled, secondhand breast milk with antibodies produce protection in another child, including toddlers or older children?
Stellwagen doesn’t know. Research is still needed on the differences between antibodies in breast milk from a vaccinated mother versus a mother with COVID-19, she says, and it’s unknown at this point how often such a feeding might have to happen to produce protective immunity.
“The big point to make is there’s such a difference between yourself having COVID or getting a vaccine and nursing your child, and giving your older child a feeding of raw or pasteurized milk, like, a couple times,” Stellwagen says.
Dr. Rahul Gupta, chief medical officer for the infant and maternal health organization March of Dimes, says there is no science or evidence yet on how secondhand breast milk with coronavirus antibodies affects immunity, nor is there any evidence that consuming breast milk as a child or an adult, rather than as a newborn, produces any significant health impact.
“There’s no recommendation in the general population, broadly speaking, to provide breast milk to older adults,” Gupta says. Any extrapolation on the impacts of donated or purchased breast milk with COVID-19 antibodies is “getting ahead of ourselves,” he says.
Stellwagen’s milk bank has only just started asking potential donors if they’ve received a COVID-19 vaccine, but she says it’s merely to track the dates of vaccination, and they haven’t decided yet what to do with the information. Milk banks often will ask about other types of vaccines donors may have received, such as one that uses a live virus and would preclude a person from donating milk for a short time. The COVID-19 vaccines in use in the U.S. are not live virus vaccines.
“We’re just keeping track for now until we figure out if it’s going to mean anything,” Stellwagen says. She does say donors have contacted the bank to say they’ve been vaccinated and have offered to donate their milk.
But that doesn’t mean everyone is interested. The Human Milk Banking Association of North America, of which Stellwagen’s milk bank is a member, asked 21 of its 31 milk banks if they’d seen an increase in post-vaccination donors who wanted to provide milk, as well as an increase in interest from recipients in milk with antibodies. According to the informal poll, only 30% of the banks said they’d seen an increase in the post-vaccinated donors, and just 10% said they’d seen increased interest in antibody-containing milk.
One milk bank, according to the association, said they were hearing moms were happy that breast milk could contain antibodies and were interested in future research on the topic. Another bank said it had three mothers decline milk because the donors had been vaccinated.
Gupta says it’s important to acknowledge that some pregnant people may be hesitant to get vaccinated, but points to Centers for Disease Control and Prevention data showing more than 90,000 people were pregnant at the time of vaccination. So far, the CDC has found no significant safety concerns for pregnant people in connection with a COVID-19 vaccine.
Meanwhile, both Rachel and Tara say they haven’t gotten much interest yet on their own ads. It’s Tara’s first time selling, she says, and she is still trying to weed out whether requests are scams or not. As for Rachel, a more veteran seller, she isn’t sure if the antibody aspect is enticing anyone.
“As far as the antibody component, it doesn’t seem to be drawing anybody else to it,” Rachel says. “But, I also have an ad that’s not paid for – it’s just a very basic ad – and there are thousands of ads on there.”