Women with multiple sclerosis who breastfeed exclusively for at least two months appear less likely to experience a relapse within a year after their baby's birth, according to a report published in the Archives of Neurology.

Multiple sclerosis is a chronic inflammatory disease of the central nervous system that predominantly affects women in their childbearing years. It is well known that women with multiple sclerosis have fewer relapses during pregnancy and a high risk of relapse in the postpartum period.
Medications used to treat multiple sclerosis by modifying the immune system, including Interferon beta and Natalizumab, are not recommended for use during pregnancy or breastfeeding. Therefore, women with multiple sclerosis who give birth must choose between nursing and resuming multiple sclerosis treatment.

Annette Langer-Gould, then of Stanford University School of Medicine, and now of Kaiser Permanente Southern California, and colleagues studied 32 pregnant women with multiple sclerosis and 29 pregnant women without multiple sclerosis who were the same age. The participants were interviewed about clinical, menstrual and breastfeeding history during each trimester and again two, four, six, nine and 12 months after they gave birth. In addition, neurological examination findings were collected from the physicians of women with multiple sclerosis.

More healthy women than women with multiple sclerosis breastfed ( 96 percent vs. 69 percent ), and among those who did breastfeed, women with multiple sclerosis were more likely to begin daily formula feedings within two months after birth ( 30 percent compared with 18 percent ). Of the 52 percent of women with multiple sclerosis who did not breastfeed or began regular supplemental feedings within two months postpartum [ 15 women ], 87 percent [ 13 women ] had a postpartum relapse, compared with 36 percent [ five women ] of the women with multiple sclerosis who breastfed exclusively for at least two months postpartum [ 14 women ]. Women with multiple sclerosis and healthy women who breastfed exclusively had significantly prolonged lactational amenorrhea, which was associated with a decreased risk of relapse in women with multiple sclerosis.

Most women with multiple sclerosis who did not breastfeed or supplemented with formula feedings ( 11 women, or 73 percent ) reported that their primary reason for doing so was to take medications for multiple sclerosis. Eight of them ( 53 percent ) resumed multiple sclerosis medications within two months after birth.

Why breastfeeding might be beneficial in humans with an autoimmune disease like multiple sclerosis has not been studied. Studies of immunity and breastfeeding, while plentiful, are predominantly focused on breast milk content and health benefits to the infant. Little is known about maternal immunity during breastfeeding.

The results suggest that women with multiple sclerosis should be encouraged to breastfeed exclusively for at least the first two months after birth instead of resuming medications.

Source: Archives of Neurology, 2009

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