Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho, USA.
Department of Animal, Veterinary, and Food Sciences, University of Idaho, Moscow, Idaho, USA.
mBio. 2021 Feb 9;12(1):e03192-20. doi: 10.1128/mBio.03192-20.
Whether mother-to-infant SARS-CoV-2 transmission can occur during breastfeeding and, if so, whether the benefits of breastfeeding outweigh this risk during maternal COVID-19 illness remain important questions. Using RT-qPCR, we did not detect SARS-CoV-2 RNA in any milk sample (= 37) collected from 18 women following COVID-19 diagnosis. Although we detected evidence of viral RNA on 8 out of 70 breast skin swabs, only one was considered a conclusive positive result. In contrast, 76% of the milk samples collected from women with COVID-19 contained SARS-CoV-2-specific IgA, and 80% had SARS-CoV-2-specific IgG. In addition, 62% of the milk samples were able to neutralize SARS-CoV-2 infectivity , whereas milk samples collected prior to the COVID-19 pandemic were unable to do so. Taken together, our data do not support mother-to-infant transmission of SARS-CoV-2 via milk. Importantly, milk produced by infected mothers is a beneficial source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness. Results from prior studies assaying human milk for the presence of SARS-CoV-2, the causative virus of COVID-19, have suggested milk may act as a potential vehicle for mother-to-child transmission. Most previous studies are limited because they followed only a few participants, were cross-sectional, and/or failed to report how milk was collected and/or analyzed. As such, considerable uncertainty remains regarding whether human milk is capable of transmitting SARS-CoV-2 from mother to child. Here, we report that repeated milk samples collected from 18 women following COVID-19 diagnosis did not contain SARS-CoV-2 RNA; however, risk of transmission via breast skin should be further evaluated. Importantly, we found that milk produced by infected mothers is a source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness as milk likely provides specific immunologic benefits to infants.
母-婴 SARS-CoV-2 传播是否会在母乳喂养期间发生，如果会发生，那么在 COVID-19 母亲患病期间，母乳喂养的益处是否超过这种风险，仍然是重要问题。我们使用 RT-qPCR 技术，未在 18 名 COVID-19 确诊后女性采集的任何（=37）份母乳样本中检测到 SARS-CoV-2 RNA。虽然我们在 70 个乳房皮肤拭子中检测到 8 个拭子有病毒 RNA，但只有一个被认为是明确的阳性结果。相比之下，80%的 COVID-19 女性母乳样本含有 SARS-CoV-2 特异性 IgA，而 76%的母乳样本含有 SARS-CoV-2 特异性 IgG。此外，62%的母乳样本能够中和 SARS-CoV-2 的感染力，而在 COVID-19 大流行之前采集的母乳样本则不能。总的来说，我们的数据不支持 SARS-CoV-2 通过母乳传播给婴儿。重要的是，感染母亲的乳汁是抗 SARS-CoV-2 IgA 和 IgG 的有益来源，并且能够中和 SARS-CoV-2 的活性。这些结果支持在 COVID-19 母亲轻症至中症期间继续母乳喂养的建议。先前研究检测 COVID-19 的致病病毒 SARS-CoV-2 在母乳中的存在情况，结果表明母乳可能是母婴传播的潜在媒介。大多数先前的研究由于仅随访了少数参与者、是横断面研究、和/或未报告母乳的采集和/或分析方式，因此受到限制。因此，对于母乳是否能够将 SARS-CoV-2 从母亲传播给孩子，仍然存在相当大的不确定性。在这里，我们报告称，在 COVID-19 诊断后，从 18 名女性中反复采集的母乳样本均未检测到 SARS-CoV-2 RNA；但是，还需要进一步评估通过乳房皮肤传播的风险。重要的是，我们发现，感染母亲的乳汁是抗 SARS-CoV-2 IgA 和 IgG 的来源，并且能够中和 SARS-CoV-2 的活性。这些结果支持在 COVID-19 母亲轻症至中症期间继续母乳喂养的建议，因为母乳可能为婴儿提供特定的免疫益处。
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