There may be a benefit to exclusive breastfeeding for women with multiple sclerosis (MS). Women with MS who breastfed their infants exclusively for two months had a lower risk of relapse during the first six months after giving birth, compared with women who did not breastfeed exclusively, according to an article published online ahead of print August 31 in JAMA Neurology.
Previous investigations found that about 20% to 30% of women with MS experience a relapse within three to four months post partum. Currently, there are no therapies or interventions to prevent a relapse, and data on the effect of breastfeeding on postpartum MS relapse are conflicting.
Kerstin Hellwig, MD, a neurologist at St. Josef-Hospital at Ruhr-University Bochum in Germany, and colleagues collected data from 201 pregnant women with relapsing-remitting MS. Each woman was monitored for any relapse for as long as one year after birth. Of these participants, 120 (59.7%) chose to breastfeed exclusively for at least two months, while 42 (20.9%) opted for a combined breastfeeding–supplemental regimen, and 39 (19.4%) did not intend to breastfeed at all. Most of the women (88.6%) in the study cohort had used disease-modifying therapies (DMTs) before pregnancy.
Of the women who breastfed exclusively, 29 (24.2%) experienced a relapse within six months post partum, compared with 31 (38.3%) of those who did not breastfeed exclusively. The effect of exclusive breastfeeding “seems to be plausible,” Dr. Hellwig and coauthors said, since disease activity returned in the second half of the postpartum year in exclusively breastfeeding women, corresponding to the introduction of supplemental feedings and the return of menses.
Dr. Hellwig and colleagues also reported that, compared with women who breastfed exclusively, those who resumed DMTs early had a higher risk of postpartum relapse.
“Relapse in the first six months post partum may be diminished by exclusive breastfeeding, but once regular feedings are introduced, disease activity is likely to return,” Dr. Hellwig and colleagues said. “Taken together, our findings suggest that exclusive breastfeeding acts like a modestly effective treatment with a natural end date.” The researchers concluded that “Women with MS should be supported if they choose to breastfeed exclusively, since it clearly does not increase the risk of postpartum relapse.”
—Ashley Payton
