Exclusive Breastfeeding and the Effect on Postpartum Multiple Sclerosis Relapses

Abstract

Quiz Ref ID Approximately 20% to 30% of the women with multiple sclerosis (MS) in historical and contemporary cohorts experience a relapse within the first 3 to 4 months post partum.^1,2 Even in the modern treatment era, there are no documented interventions for effective prevention of postpartum relapse. The effect of exclusive breastfeeding—a natural and overall beneficial option for mother and child³—on postpartum risk of MS relapse is controversial.^4,5 A few studies^2,6 found that exclusive breastfeeding for at least the first 2 months post partum might be beneficial; other studies, which defined breastfeeding crudely and/or measured breastfeeding retrospectively, did not confirm a beneficial effect on the postpartum risk of relapse.^7-9 Quiz Ref ID Because exclusive breastfeeding is physiologically different from breastfeeding with supplemental feeding or not breastfeeding¹⁰ and social pressures strongly influence breastfeeding choices the effect must be measured carefully and prospectively. It is also important to examine this issue in a large, modern cohort because the results of older cohorts may no longer be generalizable to women who receive MS medications before pregnancy.