Breastfeeding May Delay Multiple Sclerosis Relapse Postpartum

Exclusively breastfeeding may diminish MS relapse in the first 6 months after giving birth.

Pregnant women with multiple sclerosis (MS) should consider exclusive breastfeeding for at least 2 months postpartum, a recent study indicates.

Researchers established that this could reduce the risk of relapse during the first 6 months after giving birth compared with women who did not breastfeed exclusively. According to the study, approximately 20 to 30% of women with MS experience a relapse in disease activity within the first 3 to 4 months after giving birth.

Currently there are no preventive measures that can be taken to avoid postpartum relapse. The effect of exclusive breastfeeding on the postpartum risk of MS relapse is controversial with conflicting study results.

Kerstin Hellwig, MD, and colleagues analyzed data from 201 pregnant women with MS collected between 2008 and 2012, with a 1-year follow up postpartum. Exclusive breastfeeding was defined as having no regular meals interspersed throughout the period of time breastfeeding occurred compared with nonexclusive breastfeeding or no breastfeeding.

Of the women evaluated, 59% intended to breastfeed exclusively for at least 2 months, 20% combined breastfeeding with supplemental feedings within the first 2 months after giving birth, and 19% did not breastfeed. Approximately 88% of the women involved in the study used disease-modifying therapy (DMT) prior to pregnancy.

The 31 women who did not breastfeed experienced a relapse in their disease within the first 6 months postpartum, according to the study results.

With the introduction of supplemental feedings and the return of menstruation, however, even those exclusively breastfeeding for the 2 months postpartum experienced relapse after 6 months. This is due to the fact that a woman’s hormonal status changes as a result of introducing regular feedings to the infant, resulting in the return to ovulation.

The authors also note that the study had some limitations in evaluating a group of women with such a high rate of DMT use.

“Taken together, our findings indicate that women with MS should be supported if they choose to breastfeed exclusively since it clearly does not increase the risk of postpartum relapse. Relapse in the first 6 months postpartum may be diminished by exclusive breastfeeding, but once regular feedings are introduced, disease activity is likely to return,” the study concluded.