Background Limited 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). Objective To 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. Methods Using 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. Results SARS-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. Conclusion Milk 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.
【저자키워드】 COVID-19, antibodies, SARS-CoV-2, Breastfeeding, immunoglobulins, human milk, passive immunity, IgA, 【초록키워드】 coronavirus disease, coronavirus, spike glycoprotein, Infection, diagnostic, Diagnosis, risk, detection, Receptor binding domain, Immunoglobulin, RBD, swabs, Study design, SARS-CoV-2 RNA, Swab, women, Concentration, COVID-19 symptom, Support, acute respiratory syndrome, 95% CI, COVID-19 illness, Positive test, milk, coughing, positive, MOST, recommendation, objective, benefit, lactating women, anti-RBD IgA, Seven, Result, produced, tested, analyzed, collected, onset of symptom, Limited, the SARS-CoV-2, was tested, with COVID-19, 【제목키워드】 SARS-CoV-2 RNA, persistent, milk, Level,