<泌乳新知分享: 哺乳婦女接種COVID-19疫苗後,母乳中出現新冠病毒特異性抗體>
原文題目: SARS-CoV-2–Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women
文獻來源: https://jamanetwork.com/journals/jama/fullarticle/2778766
JAMA. 2021;325(19):2013-2014. doi:10.1001/jama.2021.5782
這篇研究出自以色列,收集了2020/12/23到2021/01/15期間,84位接種2劑 Pfizer-BioNTech 疫苗(間隔21天)的哺乳婦女,在接種前與接種後兩週開始,每週收集母乳樣本(n=504)進行分析,共六週。
結果一: 在第一劑疫苗接種兩週後, 母乳中特異性免疫球蛋白anti–SARS-CoV-2-specific IgA 平均濃度明顯增加,其中61.8%的樣本檢測為陽性。當第二劑接種後一週時檢測時,有86.1%的樣本為陽性。追蹤期間濃度持續升高,在第六週時,65.7%的樣本檢測為陽性。
結果二: 在頭三週母乳中特異性免疫球蛋白anti–SARS-CoV-2-specific IgG仍為低濃度,在第四週(第二劑接種後一週)明顯增加,其中91.7%的樣本檢測為陽性,到第五週和第六週時,增加到97%的樣本為陽性。
結果三: 這個研究中的母親與嬰兒均未發生嚴重疫苗不良反應事件。47位婦女(55.9%)表示在接種第一劑疫苗後有不適症狀,52位婦女(61.9%)在接種第二劑疫苗後有不適症狀,最常見的抱怨為局部疼痛。有四位嬰兒在母親接種疫苗後發燒,分別在接種疫苗後的第7, 12, 15, 與 20 天。這些嬰兒均有咳嗽、鼻塞等上呼吸道感染症狀,三位嬰兒自然痊癒,有一位嬰兒由於月齡較小,入院接受詳細檢查以及預防性抗生素治療。沒有其他相關不良事件報告。
結論: 這個研究發現疫苗接種後六週內,母乳中的特異性免疫球蛋白SARS-CoV-2 specific IgA 與 IgG均明顯增加。IgA 較早開始出現,在疫苗接種後兩週明顯增加,IgG 則在四週後(第二劑接種後一週)大幅增加。
毛醫師讀後感想:
1. 這篇研究提供了實際證據,證明接種疫苗讓母親產生了抗體,不僅保護了自己,也透過母乳提供抗體給嬰兒,為嬰兒提供保護。
容我插播一下: 不只是打疫苗,母乳在日常生活中也會持續提供抗體給寶寶,不論奶量多或少皆有抗體。所以我們一直強調部分哺乳優於零哺乳,「有吃有保庇」,希望想退奶的家長理解這個觀念,找到生活中哺乳或擠乳的平衡點,保留這個部分哺乳持續讓孩子喝到抗體的選項;也請已經退奶的家長不要氣餒,若希望再度泌乳,都可以與泌乳顧問討論的。
2. 雖然與目前國內接種的COVID-19疫苗廠牌不同,但可做為參考。期待日後其他廠牌疫苗的研究報告,讓我們對各廠牌疫苗更了解,也更有信心。
最後回答常見提問
1. 哺乳媽媽可以打AZ新冠疫苗嗎?
答:可以,只要沒有禁忌症,哺乳媽媽可以接種新冠疫苗,目前每個廠牌的疫苗建議都類似。且哺乳媽媽接種疫苗後,母乳中會有抗體提供給寶寶,可說有一人接種,保護兩人的效果。
2. 哺乳媽媽接種新冠疫苗前後需要停止哺乳嗎?需要改成擠奶嗎?
答:不需要,依照原本哺乳/擠乳方式正常生活即可。若因為疫苗副作用造成不適,請多休息多補充水分,適當使用退燒止痛藥,並不影響哺乳。突然停止哺乳或改變為擠出奶水瓶餵,反而可能增加媽媽負擔,不利於母親休息。
3. 簡單結論: 哺乳媽媽只要沒有禁忌症,可以接種新冠疫苗,接種疫苗後請多休息多喝水,維持原本哺乳或擠乳方式即可。
相關參考資料:
疾管署COVID-19疫苗Q&A
https://www.cdc.gov.tw/Category/QAPage/JCyOJznV52tt35_bDBeHfA
英國皇家婦產科醫學會: COVID-19 vaccines, pregnancy and breastfeeding
https://www.rcog.org.uk/en/guidelines-research-services/coronavirus-covid-19-pregnancy-and-womens-health/covid-19-vaccines-and-pregnancy/covid-19-vaccines-pregnancy-and-breastfeeding/
美國CDC: COVID-19 Vaccines While Pregnant or Breastfeeding
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html
#COVID19疫苗
#母乳中的抗體
#哺乳母親接種新冠疫苗
#國際認證泌乳顧問ibclc
#毛醫師哺乳諮詢門診
#喬依哺育
同時也有10000部Youtube影片,追蹤數超過2,910的網紅コバにゃんチャンネル,也在其Youtube影片中提到,...
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breastfeeding guidelines 在 9bulan10hari Facebook 的最讚貼文
Si manja ibu sudah boleh makan buah dan sayur. Wah, seronoknya! 🤩
Buah-buahan dan sayur-sayuran membekalkan pelbagai vitamin, mineral dan serat untuk fungsi normal tubuh si manja. Pastikan si manja ibu mendapat khasiat pelbagai buah dan sayur setiap hari.
Sebagai permulaan, ibu boleh berikan sebanyak 1 sudu makan buah-buahan lembut yang dipuri, lecek atau separa pepejal 2 kali sehari kepada mereka.
DAN
1 sudu makan sayuran berwarna hijau atau jingga yang dipuri atau lecek 3 kali sehari kepada mereka.
Tips pemberian makanan kepada si manja:
1. Banyakkan bersabar dan berinteraksi secara positif dengan si manja
2. Teruskan penyusuan susu ibu mengikut kehendak bayi.
Sumber rujukan:
Garis Panduan Pemberian Makanan Bayi dan Kanak-Kanak Kecil (2009)
Kredit: Pusat Maklumat Pemakanan Negeri Pahang
The Pampered Mother can already eat fruits and vegetables. Wow, it's fun! 🤩
Fruits and vegetables supply a variety of vitamins, minerals and fiber for the normal function of the spoiled body. Make sure the mother's mother gets the benefits of various fruits and vegetables every day.
As a start, mother can give 1 tablespoon of soft, mash or semi-Solid Fruits 2 times a day to them.
And
1 tablespoon of green or orange greens that are dipuri or MASH 3 times a day to them.
Tips to give food to the little one:
1. Be patient and interact positively with the little one
2. Continue Breastfeeding Mother's milk according to the will of the baby.
Source of reference:
Small baby and child food guidelines (2009)
Credit: @[103445303369069:274:Pusat Maklumat Pemakanan Negeri Pahang]Translated
breastfeeding guidelines 在 Lawrence Wong 王冠逸 Facebook 的最佳解答
Guys. I really don't know how else to remind you to stay home and stop meeting people you don't live with. It's not about meeting multiple small groups of people at different times of the week and it being "okay" because it's less than 10 people.
In case you haven't noticed, the curve has been exponentially rising in Singapore. And these are not just imported cases. The number of unlinked local cases are growing each day. Just because we're not officially locked down doesn't mean you can flirt with the guidelines. It just means that the government has considered that locking down will bring the economy into an even quicker freefall without solving the problem of rate of infection, among other delicate repercussions that I won't go into here because if you're woke enough, dozens of other people have already written about it and made their pleas to ask you to stay home.
Just go read about what happened when India suddenly locked down over night. Or the people stories coming out from Malaysia of who suffers on the fringes when lockdown happens.
Those of us who are privileged middle and upper class who have the option of multiple comforts should we be forced to stay home really need to remember that this is not about us.
Of course no one believes they are going to be the one to start a cluster. Do you think the principal of that particular sparkletots preschool went to work thinking she was going to be part of a cluster of 26 positive cases? And what makes you think she was solely responsible? What if she was infected by a family member but those cases were only discovered after her?
Just because you don't think it will happen to you doesn't mean you get to be socially irresponsible.
We are believers, yes. We receive and stand on the word of God and His promise of protection, yes. But it doesn't give us the right to be irresponsible and dishonoring of government regulations in a time such a this. Like I said, "my gathering was less than 10 people" is not respecting the rule but flirting with the rule.
Please think of the parents whose 5 year old needed to get tested for Covid-19 because she had pneumonia, the breastfeeding mom who has to be separated from her child because either of them tests positive or simply because of quarantine, the health care workers who also have family and are so afraid to even touch or hug their own children because they are afraid that they are next.
Please look at this curve and understand that while we have an excellent health care system, when the majority of the finite resources in your system is directed to addressing this singular cause, there will come a breaking point where it will mean less resources for everyone else going through anything else in this same window. If you get into an accident. The cancer patients. Anyone else who needs the ICU. Ventilators. Respirators.
There is so much more I can say. But so many others have already said it. Have made their pleas. So please if there's anything to stay woke about right now, stay informed. Be responsible. Stay at home. I don't care if you're an extrovert or a social butterfly. Can you just please don't meet friends in real life for a few weeks. I promise you that you won't die. But if you meet them, the probability of someone dying, be it yourself, someone you know, or someone they know, increases exponentially.
Don't just look at the measures and the delicate balance that the government is trying so hard to maintain and think to yourself that as long as we haven't gone to dorscon red that it is "not that bad yet". The government is trying to reason with us believing that we can be socially responsible adults that will know the right thing to do. But they think too highly of us. Many people are still acting like teenagers who need to be grounded to their rooms and given consequences for their actions.
Please. Stay. Home. (Yes I know we all need to eat and get food and run quick errands and get some fresh air downstairs. I'm referring to intentionally meeting any groups of friends/family or strangers for a prolonged span of time when it is neither crucial or necessary to do so). Any other option is selfish and irresponsible.
breastfeeding guidelines 在 コバにゃんチャンネル Youtube 的最佳貼文
breastfeeding guidelines 在 大象中醫 Youtube 的精選貼文
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