TY - JOUR T1 - SARS-CoV-2 RNA and antibody detection in breast milk from a prospective multicentre study in Spain JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed DO - 10.1136/archdischild-2021-322463 SP - fetalneonatal-2021-322463 AU - Christine Bäuerl AU - Walter Randazzo AU - Gloria Sánchez AU - Marta Selma-Royo AU - Elia García Verdevio AU - Laura Martínez AU - Anna Parra-Llorca AU - Carles Lerin AU - Victoria Fumadó AU - Francesca Crovetto AU - Fatima Crispi AU - Francisco J Pérez-Cano AU - Gerardo Rodríguez AU - Gemma Ruiz-Redondo AU - Cristina Campoy AU - Cecilia Martínez-Costa AU - Maria Carmen Collado A2 - , Y1 - 2021/08/19 UR - http://fn.bmj.com/content/early/2021/09/10/archdischild-2021-322463.abstract N2 - Objectives To develop and validate a specific protocol for SARS-CoV-2 detection in breast milk matrix and to determine the impact of maternal SARS-CoV-2 infection on the presence, concentration and persistence of specific SARS-CoV-2 antibodies.Design and patients This is a prospective, multicentre longitudinal study (April–December 2020) in 60 mothers with SARS-CoV-2 infection and/or who have recovered from COVID-19. A control group of 13 women before the pandemic were also included.Setting Seven health centres from different provinces in Spain.Main outcome measures Presence of SARS-CoV-2 RNA in breast milk, targeting the N1 region of the nucleocapsid gene and the envelope (E) gene; presence and levels of SARS-CoV-2-specific immunoglobulins (Igs)—IgA, IgG and IgM—in breast milk samples from patients with COVID-19.Results All breast milk samples showed negative results for presence of SARS-CoV-2 RNA. We observed high intraindividual and interindividual variability in the antibody response to the receptor-binding domain of the SARS-CoV-2 spike protein for each of the three isotypes IgA, IgM and IgG. Main Protease (MPro) domain antibodies were also detected in milk. 82.9% (58 of 70) of milk samples were positive for at least one of the three antibody isotypes, with 52.9% of these positive for all three Igs. Positivity rate for IgA was relatively stable over time (65.2%–87.5%), whereas it raised continuously for IgG (from 47.8% for the first 10 days to 87.5% from day 41 up to day 206 post-PCR confirmation).Conclusions Our study confirms the safety of breast feeding and highlights the relevance of virus-specific SARS-CoV-2 antibody transfer. This study provides crucial data to support official breastfeeding recommendations based on scientific evidence. Trial registration number NCT04768244.Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Data are available upon request. All data relevant to the study are included in the article or uploaded as supplementary information. ER -