Is BCG Vaccine compatible with breastfeeding? Do we have alternatives for BCG Vaccine?

BCG Vaccine

May 19, 2017 (Very Low Risk)

Live bacilli modified from a bacillus Calmette-Guerin strain (Mycobacterium tuberculosis, bovis variety).

This vaccine is commonly given to newborns and infants in many countries (Montagnani 2016, Mittal 2014, Goh 1989).

The Centers for Disease Control and Prevention, health experts and several health organizations indicate that vaccines - whether from live attenuated, dead or inactivated microorganisms, or from subunits or toxoids of the same - when administered to breastfeeding mothers do not affect breastfeeding or the safety of mothers or infants and that breastfeeding is not a contraindication for the tuberculosis vaccine (Sachs 2013, ACIP-MMWR 2011, Red Book 2009, Gruslin 2009, Clements 1996, ACIP-MMWR 1989).

Breastfeeding increases the immunogenicity of some vaccines (ACIP-MMWR 2011, Pabst 1997), such as BCG when administered on the first day of life (Red Book 2009, Pabst 1989).

Breastfeeding women can and should be protected with recommended vaccines like other adults (Red Book 2009, Clements 1996).
Newborns and infants should be immunized according to current vaccination schedules, regardless of whether or not they are breastfed (ACIP-MMWR 2011, Red Book 2009).

List of essential medicines WHO 2002: the BCG vaccine is compatible with breastfeeding (WHO / UNICEF 2002).

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Bacillus Calmette-Guérin Vaccines

Writings

  • μυκοβακτηρίδιο φυματίωσης εμβόλιο (Greek)
  • Вакцины БЦЖ (Cyrillic)
  • BCG ワクチン (Japanese)

Drug trade names

References

  1. Montagnani C, Esposito S, Galli L, Chiappini E, Principi N, de Martino M; Italian Pediatric TB Study Group.. Recommendations for pediatric tuberculosis vaccination in Italy. Hum Vaccin Immunother. 2016Abstract
  2. Mittal H, Das S, Faridi MM. Management of newborn infant born to mother suffering from tuberculosis: current recommendations & gaps in knowledge. Indian J Med Res. 2014Abstract Full text (link to original source) Full text (in our servers)
  3. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013Abstract Full text (link to original source) Full text (in our servers)
  4. Red Book. Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red Book: 2012 Report of the Committee on Infectious Diseases. 29th ed. Elk Grove Village, Red Book 2012
  5. National Center for Immunization and Respiratory Diseases. General recommendations on immunization --- recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011Abstract Full text (in our servers)
  6. National Center for Immunization and Respiratory Diseases.. General recommendations on immunization --- recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011Abstract
  7. Gruslin A, Steben M, Halperin S, Money DM, Yudin MH; Infectious Diseases Committee of the Society of Obstetricians and Gynaecologists of Canada.. Immunization in pregnancy. J Obstet Gynaecol Can. 2009Abstract
  8. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  9. Pabst HF, Spady DW, Pilarski LM, Carson MM, Beeler JA, Krezolek MP. Differential modulation of the immune response by breast- or formula-feeding of infants. Acta Paediatr. 1997Abstract
  10. Clements J. Opportunities to immunise. Child Health Dialogue. 1996Abstract
  11. [No authors listed] General recommendations on immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 1994Abstract Full text (in our servers)
  12. Goh TE, Low M, Chen CH, Tan TH. A comparative study of Japanese and British BCG vaccine strains in newborn infants. Asia Pac J Public Health. 1989Abstract
  13. Pabst HF, Godel J, Grace M, Cho H, Spady DW. Effect of breast-feeding on immune response to BCG vaccination. Lancet. 1989Abstract