UMMS Affiliation

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine; School of Medicine

Publication Date


Document Type



Hemic and Immune Systems | Immunology of Infectious Disease | Infectious Disease | Maternal and Child Health | Microbiology | Virus Diseases


Objective: To evaluate the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in colostrum from women who tested positive for the virus.

Methods: Between March and September 2020 we obtained bilateral colostrum samples collected on spot cards within 48 hours of delivery from 15 new mothers who had previously tested positive for SARS-CoV-2. Four of 15 women provided liquid colostrum, which was used for validating results obtained from spot cards. Archived bilateral colostrum samples collected from 8 women during 2011-2013 were used as pre-coronavirus disease 2019 (COVID-19) controls. All samples were tested for reactivity to the receptor binding domain (RBD) of the SARS-CoV-2 spike protein using an enzyme-linked immunosorbent assay that measures SARS-CoV-2 RBD-specific IgA, IgG, and IgM and for levels of 10 inflammatory cytokines (interferon-gamma [IFN-gamma], tumor necrosis factor-alpha, interleukin [IL]-1beta, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13) using a multiplex electrochemiluminescent sandwich assay.

Results: Our validation studies indicate that the levels of SARS-CoV-2-specific antibodies and the associated cytokines measured in liquid colostrum are comparable to levels eluted from spot cards. Bilateral colostrum samples from 73%, 73%, and 33% of the 15 COVID-19 mothers exhibited IgA, IgG, and IgM reactivity to RBD, respectively. In addition, symptomatic COVID-19 mothers had statistically significant elevated levels of 4 of the 10 inflammatory markers (IFN-gamma, IL-4, IL-6, and IL-12) compared to asymptomatic COVID-19 mothers.

Conclusions: A strong humoral immune response is present in the colostrum of women who were infected with SARS-CoV-2 before delivering. The evolution and duration of the antibody response, as well as dynamics of the cytokine response, remain to be determined. Our results also indicate that future large-scale studies can be conducted with milk easily collected on paper spot cards.


COVID-19, SARS-CoV-2, antibody, breast milk, breastfeeding, colostrum, cytokine

Rights and Permissions

Copyright Vignesh Narayanaswamy et al. 2021; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

DOI of Published Version



Narayanaswamy V, Pentecost B, Alfandari D, Chin E, Minor K, Kastrinakis A, Lieberman T, Arcaro KF, Leftwich H. Humoral and Cell-Mediated Immune Response in Colostrum from Women Diagnosed Positive for SARS-CoV-2. Breastfeed Med. 2021 Aug 11. doi: 10.1089/bfm.2021.0082. Epub ahead of print. PMID: 34382820. Link to article on publisher's site

Journal/Book/Conference Title

Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine

Related Resources

Link to Article in PubMed

PubMed ID


Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.