A few weeks ago, a lucky friend with a beautiful new baby shared a link on Facebook from the web site “Natural News” that grabbed my attention, and as a nursing mother, hers, too.
The Natural News is part of a company called The NaturalNews Network, and, according to their site, “is owned and operated by Truth Publishing International, Ltd., a Taiwan corporation.”
The headline read:
“CDC researchers say mothers should stop breastfeeding to boost the ‘efficacy’ of vaccines” was the headline.
What? Stop breastfeeding?
I’d just written a story for our February issue on Baby Steps to Breastfeeding, a state initiative to help support mothers with their breastfeeding goals.
I had been all over the Centers for Disease Control (CDC) site. I researched the Surgeon General’s Call to Action, an initiative that “seeks to make it possible for every mother who wishes to breastfeed to be able to do so by shifting how we as a nation think and talk about breastfeeding.”
I finished that story understanding that increasing breastfeeding rates and duration had truly become a public health issue, and that we’d come a long way since the days when formula feeding was the default choice.
So I was stunned to think that CDC researchers would say “mothers should stop breastfeeding to boost the ‘efficacy’ of vaccines.”
I wanted to dig a little deeper.
The study the Natural News wrote about was actually the link to an abstract. For anyone who isn’t familiar with the way scientific research is presented, an abstract is a short version of a study with just the facts spelling out what was studied.
Abstracts are written in scientific lingo, and not so easy for the lay person to understand. It’s a science thing.
I wasn’t sure exactly what the study meant even after reading the abstract; I’m a lay person type.
The purpose of the study, according to the authors, was to find out why rotovirus vaccines have been less effective on children in poor developing countries compared with middle income and industrialized countries.
But what did that have to do with stopping breastfeeding?
As a health writer for Raising Arizona Kids, and as a journalist, when I don’t understand what study findings actually mean, I start asking questions. I find experts who can help translate scientific speak – so that I can pass that information on to our readers.
So I sent the link to the Natural News column along with a link to the abstract to the Arizona Chapter of the American Academy of Pediatrics (AZAAP) to find out what the study findings really meant.
And, I wanted to know if the findings had any bearing on women in the U.S.
Were researchers for the CDC trying to discourage women from breastfeeding? Were they trying to push vaccines in lieu of breastfeeding? Was there some kind of conspiracy going on that I didn’t know about? What’s the rotovirus anyway? I’d never heard of anyone catching that in this country.
Here’s the answer to my questions from AZAAP members Karen Lewis, M.D., F.A.A.P., who is the medical director of the Arizona Immunization Program Office at the Arizona Department of Health Services, and Sudha Chandrasekhar, M.D., M.P.H., F.A.A.P., the breastfeeding coordinator of Gateway Pediatrics in Chandler.
What is rotovirus?
Rotavirus is the most common cause of severe diarrhea in children under 5 years of age. Rotavirus disease is responsible for over 500,000 deaths a year in the world, with more than 85% of deaths occurring in low income countries.
The U.S. has much lower death rates from rotavirus than low income countries, but rotavirus infections in the US still cause significant suffering and economic burden due to dehydration, doctor visits, and hospitalizations.
When is this vaccine given to babies?
Rotavirus vaccine is recommended as a routine vaccine for infants, either as 2 or 3 doses depending on the manufacturer. The rotavirus vaccine is a “live” vaccine. It stimulates the immune system by growing in the intestines.
Therefore, substances that slow the growth of the rotavirus vaccine virus could possibly decrease how well the vaccine stimulates the immune system.
Wouldn’t breast milk have enough immune support to protect a baby from the virus? For any baby, anywhere in the world?
Even when mothers breastfeed, their infants can still get sick and die from rotavirus. Since rotavirus kills so many infants in low income countries, it is important to find ways to make sure that rotavirus vaccines can work as effectively as possible.
However, clinical studies have shown that children in low income countries do not get as good of protection from rotavirus vaccine as children in high income countries. Researchers have suggested that this could be due to breast milk providing such good natural immunity that it slows down the growth of the rotavirus vaccine virus, making the vaccines less effective.
But the study seems to imply that researchers want mothers to discontinue breastfeeding. That’s the what the Natural News opinion writer is proposing.
Breastfeeding is wonderful nutrition. In addition, it strengthens infants’ immunity by providing them with white blood cells and antibodies from their mothers.
Unfortunately formula is often substituted for breastfeeding. When this happens in lower income countries, the combination of mixing formula with contaminated water and poor community sanitation greatly increases the risk of illness and death. Therefore, it is crucial to encourage breastfeeding in low income countries.
So researchers set out to prove that breastfeeding might actually prevent the vaccine from working? Does this apply to women and babies in the U.S.?
Dr. Sung-Sil Moon and associates studied this theory, and published their findings in the October 2010 issue of the Pediatric Infectious Disease Journal in an article entitled “Inhibitory Effect of Breast Milk on Infectivity of Live Oral Rotavirus Vaccines.”
They found that breast milk in Indian women had higher levels of antibodies against rotavirus than American women. When the breast milk was tested in the laboratory, breast milk from Indian women slowed down the growth of rotavirus better than breast milk from women in the U.S.
This research suggests that when a mother’s breast milk has high levels of rotavirus antibody, breastfeeding may slow down the vaccine virus enough so that the vaccine doesn’t work as well as it could.
So the breast milk antibody level differs in women around the world?
In addition, the article pointed out that since antibody levels against rotavirus in the breast milk of U.S women are much lower, it would not be expected that mothers who breastfeed in the U.S. would have high enough antibody levels to decrease the effectiveness of the rotavirus vaccine.
Based on these new findings, the authors discussed whether the rotavirus vaccine virus would be more effective in low income countries if mothers were to delay breastfeeding for a short time before and after rotavirus vaccine was given to their infants.
Delay? What does it mean when they use the word “delay” in the abstract? That’s confusing.
The authors did not specify the length of time that might be needed. In order to answer the question about delaying breastfeeding, they would have to decide on what they thought was a reasonable time period for a delay, write a proposal, and conduct a clinical trial. The authors did not go into any of those details in their current article.
Breastfeeding is essential for children’s nutrition and health and hydration—especially in a low income country where giving formula might increase a child’s risk of exposure to bacteria-contaminated water. Therefore, the logical approach would be that any “delay” would have to be short-lived.
How short is short-lived? If a mother stops breastfeeding for a certain period of time, her milk will decrease and she might not have enough milk to continue.
An educated guess would be that a delay would be more than just a few minutes, because it takes close to an hour for over half of the stomach contents to pass through the stomach.
So, for example, if a child had not received breast milk for 2 hours, there would be a lot less breast milk in the stomach to have an inhibitory effect on the vaccine. Then, by waiting an hour after vaccination to feed, there would be more time for the vaccine to get into the intestines without being slowed down by a stomach full of breast milk.
So how would researchers figure out what to recommend in terms of “delay” time?
A scientific clinical study might be done with several different time periods of delay (with clean water or formula supplementation in the interim) in order to see if the length of the delays had any different effect on the level of immunity from the vaccine. Other clinical studies might be done to see if a higher dose of vaccine could overcome the inhibitory effects of breast milk in low income countries. However, clinical studies to answer these questions may not be done in the near future because of not having any funding to do so.
I can’t emphasize enough that the discussion of “delay” in the article was part of scientific brainstorming, and not part of any recommendation. A clinical trial would have to be done to answer the questions raised by the new findings in the article. Any subsequent recommendations would be made on analyzing the benefits and risks involved. The overarching purpose would be to keep the children as safe as possible while giving them the best protection against rotavirus.
So the CDC isn’t saying that women in the United States or anywhere else should stop breast feeding, even for a short period.
No one is recommending that these mothers should stop breastfeeding, even temporarily. More studies are needed to better understand how breast feeding interacts with rotavirus vaccine before any scientific conclusions can be made.
Again, it is important to point out that there are no recommendations to stop breastfeeding around the time of rotavirus vaccination.
The Arizona Department of Health Services, the Centers for Disease Control and Prevention, and the American Academy of Pediatrics are strong supporters of breastfeeding, and strong supporters of children receiving all recommended vaccines.
RAK Breastfeeding Resources