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12-07-2011 | Neurology | Article

Breastfeeding does not protect against MS relapses

Abstract

Free abstract

MedWire News: Breastfeeding does not protect against multiple sclerosis (MS) relapses after giving birth, show study findings published in the journal Neurology.

"Breastfeeding should not be encouraged by doctors to protect against MS relapses, especially among women with MS who have high disease activity and high risk of postpartum relapses," said Emilio Portaccio from the University of Florence in Italy.

"Since it is not considered safe for women to take MS drugs while breastfeeding, breastfeeding may not be feasible for these women who may need to resume treatment to avoid relapses soon after giving birth."

Several studies on the effects of breastfeeding in women with MS have resulted in mixed findings, some suggesting no benefit and some suggesting that breastfeeding may help protect against MS relapses in these women.

Portaccio and colleagues investigated this further in 298 Italian women with MS recruited from 21 centers across the country, who had 302 full-term deliveries between 2002 and 2008. The women were followed up for at least 1 year after delivery to evaluate links between breastfeeding and relapse of their condition.

The researchers found that breastfeeding had no apparent effect on risk for relapse after giving birth with similar rates of relapse in women who breastfed compared to those who did not before, during, and after pregnancy.

Indeed, the only significant predictors of relapse after controlling for factors such as age at MS onset, age at pregnancy, treatment with disease-modifying drugs, and exposure to toxins was relapses in the year before and during pregnancy, which increased the risk for postpartum relapses 1.5 and 2.2 fold, respectively.

"Earlier reported associations between breastfeeding and a lower risk of postpartum relapses may simply reflect different patient behavior, biased by the disease activity," said Portaccio.

"Women who have fewer relapses before and during pregnancy may be more likely to breastfeed and then continue to have fewer relapses in the postpartum period. However, a course of postpartum steroids might protect against later attacks. Approaches of this type were not assessed in this study and might, in consultation with the treating neurologist, enable breastfeeding," he added.

Certainly, there is consistent evidence to show that for a large percentage of women with MS, the 12 months after birth represent a period of increased risk for relapse, during which disease-modifying drugs are likely to be required and therefore breastfeeding contraindicated.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Helen Albert

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