Although mothers with MS are at greater risk of relapse in the first 3 months post-delivery,1 those who exclusively breast-feed have a significantly reduced risk of such relapses.2 Currently, women are not recommended to continue immunomodulatory treatment during pregnancy or while breast-feeding,3 although recent studies do not indicate that such therapies are associated with prenatal developmental toxicity.4Fatigue is a common, debilitating symptom of MS, therefore expressing breast milk has certain advantages: it mimics exclusive breast-feeding while enabling others to help with feeds when the mother is tired. The mothers’ MS specialist team can provide information and advice on comfortable positioning and other practical issues, and it is important to involve them if the mother who wishes to breast-feed has any MS-associated limitations. Baby slings may also be useful, to help support infants while they are feeding.
References1. Vukusic S et al. Pregnancy and multiple sclerosis (the PRIMS study): clinical predictors of post-partum relapse. Brain 2004; 127: 1353–1360.
2. Langer-Gould A et al. Exclusive breastfeeding and the risk of postpartum relapses in women with multiple sclerosis. Arch Neurol 2009; 66: 958–963.
3. Ferrero S et al. Fetal risks related to the treatment of multiple sclerosis during pregnancy and breastfeeding. Expert Rev Neurother 2006; 6: 1823–1831.
4. Weber-Schoendorfer C et al. Multiple sclerosis, immunomodulators, and pregnancy outcome: a prospective observational study. Mult Scler 2009; 15(9): 1037-1042.
ResourceMS Society. Information on pregnancy. Available at: http://www.mssociety.org.uk/applications/search/search.rm?term=pregnancy. Accessed 12 Nov 2009.
From: Journal of Family Health Care Bulletin. Directory of Breast-Feeding Advice. December 2009. Published with JFHC 2009; 19(6). http://www.jfhc.co.uk/images/stories/breastfeeding.pdf