New research has discovered that breast milk and amniotic fluid may provide protection against COVID-19 during pregnancy.

In a new study conducted collaboratively by Swansea University and the University of Aberdeen, researchers have identified potential protective effects in breast milk and amniotic fluid that shield against COVID-19 during pregnancy, enhancing the safety of new-born babies.

The findings, funded by the EPSRC Impact Acceleration Account (IAA) at Swansea University and the Welsh Government Sêr Cymru III Tackling COVID-19 initiative, have been published in Paediatric Allergy and Immunology.

Previous research suggests that membrane-bound receptors such as ACE2, CD26, CD147, and NRP1 contribute to the entry of coronaviruses into human cells. However, earlier studies have indicated that soluble forms of the ACE2, sCD26, sCD147, and sNRP-1 protein may trap the virus in biological fluids, resulting in the prevention of cell infection by acting as a decoy.

Possible protective measures during pregnancy

Severe COVID-19 during pregnancy brings an increased risk of preterm birth and intensive care admission, and although most pregnant women who encounter symptomatic or asymptomatic COVID-19 will not experience severe side effects, it is critical there is ongoing research into preventative measures against COVID-19 in pregnant women and new-borns.

Professors and students at Swansea University and the University of Aberdeen aimed to uncover whether the concentration levels of the ACE2 protein in breast milk and amniotic fluid were significant enough to act as a protective measure in pregnancy against SARS-CoV-2. To conduct the study, test samples of breastmilk collected at two and six weeks postpartum and amniotic fluid from 37 weeks plus of gestation, donated pre-covid, were tested for the soluble receptor, ACE2.

The results determined that high concentration levels of this specific protein were discovered in both the breastmilk and amniotic fluid, therefore, suggesting that breastfeeding mothers and pregnant women have a reduced chance of infection and severity of the virus in foetuses and babies. Further examination of the proteins through imaging by the team at Swansea University and the University of Aberdeen discovered that the receptors have different isoforms, the same molecule but at varying lengths.

April Rees, a Swansea University PhD student and Biochemistry Tutor, said: “It has been a peculiar finding that babies before and after birth are relatively protected from SARS-CoV-2. Our findings here may shed some light on why that is. It adds to the argument that breastfeeding is more beneficial, and so assistance in helping mothers breastfeed is vital.”

Professor Stephen Turner, a consultant paediatrician at Royal Aberdeen Children’s Hospital and Honorary Professor at the University of Aberdeen, said: “There is a long list of good reasons why mothers should breastfeed their baby wherever possible, and protecting the baby against COVID-19 could now be added to the list. Pregnant mothers can also protect themselves, and baby, by having the COVID-19 vaccine.”

It is widely known that there is a greater risk of infection and severity in pregnant women due to a weakened immune system when compared to nonpregnant women. Therefore, it is important to provide further insight into protective measures against COVID-19 and other viral infections. Currently, COVID-19 vaccines are not approved for infants, but the findings from this study suggest that breastmilk could be an alternative way for new-borns to receive SARS-CoV-2 antibodies and provide further protection.

The research team are hoping to further investigate their recent discoveries by isolating the various isoforms to identify which is more optimal for binding the virus, evaluating whether breast milk and amniotic fluid inhibit viral entry into cells.

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