NDLI: Milk From Women Diagnosed With COVID-19 Does Not Contain SARS-CoV-2 RNA but Has Persistent Levels of SARS-CoV-2-Specific IgA Antibodies

Content Provider	Directory of Open Access Journals (DOAJ)
Author	Ryan M. Pace Janet E. Williams Kirsi M. Järvinen Courtney L. Meehan Melanie A. Martin Sylvia H. Ley Celestina Barbosa-Leiker Aline Andres Laxmi Yeruva Mandy B. Belfort Beatrice Caffé Alexandra D. Navarrete Kimberly A. Lackey Christina D. W. Pace Alexandra C. Gogel Bethaney D. Fehrenkamp Miranda Klein Bridget E. Young Casey Rosen-Carole Nichole Diaz Stephanie L. Gaw Valerie Flaherman Mark A. McGuire Michelle K. McGuire Antti E. Seppo
Abstract	BackgroundLimited data are available regarding the balance of risks and benefits from human milk and/or breastfeeding during and following maternal infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).ObjectiveTo investigate whether SARS-CoV-2 can be detected in milk and on the breast after maternal coronavirus disease 2019 (COVID-19) diagnosis; and characterize concentrations of milk immunoglobulin (Ig) A specific to the SARS-CoV-2 spike glycoprotein receptor binding domain (RBD) during the 2 months after onset of symptoms or positive diagnostic test.MethodsUsing a longitudinal study design, we collected milk and breast skin swabs one to seven times from 64 lactating women with COVID-19 over a 2-month period, beginning as early as the week of diagnosis. Milk and breast swabs were analyzed for SARS-CoV-2 RNA, and milk was tested for anti-RBD IgA.ResultsSARS-CoV-2 was not detected in any milk sample or on 71% of breast swabs. Twenty-seven out of 29 (93%) breast swabs collected after breast washing tested negative for SARS-CoV-2. Detection of SARS-CoV-2 on the breast was associated with maternal coughing and other household COVID-19. Most (75%; 95% CI, 70-79%; n=316) milk samples contained anti-RBD IgA, and concentrations increased (P=.02) during the first two weeks following onset of COVID-19 symptoms or positive test. Milk-borne anti-RBD IgA persisted for at least two months in 77% of women.ConclusionMilk produced by women with COVID-19 does not contain SARS-CoV-2 and is likely a lasting source of passive immunity via anti-RBD IgA. These results support recommendations encouraging lactating women to continue breastfeeding during and after COVID-19 illness.
e-ISSN	16643224
DOI	10.3389/fimmu.2021.801797
Journal	Frontiers in Immunology
Volume Number	12
Language	English
Publisher	Frontiers Media S.A.
Publisher Date	2021-12-01
Publisher Place	Switzerland
Access Restriction	Open
Subject Keyword	Immunologic Diseases. Allergy Antibodies Breastfeeding Covid-19 Human Milk Immunoglobulins Iga
Content Type	Text
Resource Type	Article

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