Is Influenza Vaccines Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Influenza Vaccines? Is Influenza Vaccines safe for nursing mother and child? Does Influenza Vaccines extracts into breast milk? Does Influenza Vaccines has any long term or short term side effects on infants? Can Influenza Vaccines influence milk supply or can Influenza Vaccines decrease milk supply in lactating mothers?

The Centers for Disease Control and Prevention and several health professional organizations state that vaccines given to a nursing mother do not affect the safety of breastfeeding for mothers or infants and that breastfeeding is not a contraindication to either the live, attenuated (i.e., inhaled) or inactivated (i.e., injected) influenza vaccine, including H1N1 (swine) influenza vaccine. Immunization of the mother during pregnancy increases the amount of influenza antibodies in breastmilk and may offer added protection of their breastfed infants against influenza.[1][2] Breastmilk antibody responses are higher with the inactivated influenza vaccine than with the live oral vaccine.[3] Breastfed infants should be vaccinated according to the routine recommended schedules.[4][5][6][7]

Limited data indicate that breastfeeding can enhance the response of the infant to certain vaccine antigens.[4][6][8] In a study of pregnant women who were immunized during the third trimester and breastfed their infants for an average of 14 weeks, their infants had a 36% reduction in respiratory illness with fever, and a 63% reduction in laboratory-confirmed influenza during the first 6 months of life. However, the contribution of breastfeeding compared with passive transfer of maternal antibodies during pregnancy was not determined.[9] A prospective, blinded trial in Bangladesh compared outcomes of mothers randomly assigned to receive either trivalent influenza vaccine or pneumococcal polysaccharide vaccine in the third trimester of pregnancy and their infants. Influenza-specific IgA levels were higher in the breastmilk of those immunized against influenza than pneumococcus until at least 6 months postpartum. The breastfed infants of influenza-vaccinated mothers had fewer episodes of respiratory illness with fever in the first 6 months postpartum, which was positively correlated with the extent of exclusive breastfeeding.[2] A study compared the effects of inactivated influenza vaccine (Fluzone, 2011-2012 strains) and live attenuated influenza vaccine (FluMist, 2012-2013 strains) in nursing mothers who were 28 to 120 days postpartum. The breastfed infants whose mothers received the live attenuated strain had more fussiness (60%) than those whose mothers received the inactivated vaccine (45%).[3]