Exclusive breastfeeding should be supported in women with MS

Sep 9 2015

By Eleanor McDermid, Senior medwireNews Reporter

Exclusive breastfeeding appears to have a protective effect against the return of disease activity after pregnancy in women with multiple sclerosis (MS), say researchers.

Clinical relapse was markedly less likely to occur during the first 6 months postpartum if women exclusively breastfed for at least 2 months, report Kerstin Hellwig (Ruhr-University Bochum, Germany) and study co-authors.

“The effect of exclusive breastfeeding seems to be plausible, 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”, the team writes in JAMA Neurology.

“Taken together, our findings suggest that exclusive breastfeeding acts like a modestly effective treatment with a natural end date.”

Of 201 women studied, 120 stated their intention to breastfeed exclusively for at least 2 months. Of these women, 24.2% had a relapse during the first 6 months after delivery, compared with 38.3% of those who breastfed nonexclusively or did not breastfeed.

The researchers established women’s breastfeeding intentions prospectively, to avoid recall bias. They also distinguished between exclusive and nonexclusive breastfeeding, noting that even a small amount of regular supplemental feeding can trigger the resumption of women’s menstrual cycles.

Indeed, there was no difference in the risk of postpartum relapse between the 42 women who breastfed nonexclusively and the 39 who did not breastfeed at all. By contrast, these two groups combined had a significant 70% increased risk of postpartum relapse relative to women who exclusively breastfed, after accounting for age, prepregnancy relapse frequency and relapse during pregnancy.

After introducing supplemental feeding, women who initially breastfed exclusively had a relapse rate of 39.2%, which was similar to that in women who had introduced supplemental feeding from the outset.

During the second 6 months of the postpartum year, the relapse rate was 22.5% in women who had exclusively breastfed initially and 8.6% in those who had not. So the overall relapse rate during the first year postpartum was similar in both groups, but relapse was delayed for many women who exclusively breastfed.

“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”, conclude Hellwig et al.

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