Does Breastfeeding Reduce the Risk of Multiple Sclerosis Relapse?

Women with multiple sclerosis (MS) who breastfeed their infants exclusively may have a lower risk of disease relapse for up to 6 months postpartum compared to women with MS who do not breastfeed exclusively, according to results of a study published in JAMA Neurology.

Researchers from Ruhr University Bochum in Germany studied 201 pregnant women with MS between January 1, 2008 and June 30, 2012 and followed up after one year postpartum in order to determine the effect of exclusive breastfeeding on postpartum risk of MS relapse. The researchers wanted to investigate further the effects of introducing supplemental feedings onto that risk.

Exclusive breastfeeding was defined by the researchers of at least two months of breastfeeding without regular replacement of any meal by supplemental feeding. Nonexclusive breastfeeding was defined as partial or no breastfeeding.

The researchers found that of the total population, 120 women (59 percent) intended to breastfeed exclusively for at least two months, while 42 women (20 percent) combined breastfeeding with supplemental feedings within the first two months after giving birth, and 39 women (19 percent) did not breastfeed. Additionally, most of the women, 88 percent, had used disease modifying therapy (DMT) agents before pregnancy.

The women with MS who intended to breastfeed their infants for at least two months had a lower risk of relapse during the first six months postpartum compared to the women who did not breastfeed exclusively, the researchers found. Nearly two in five women (38 percent) who did not breastfeed exclusively had MS relapse within the first six months compared to about 25 percent of women who intended to breastfeed exclusively for at least two months postpartum.

The researchers added in a press release that between 20 and 30 percent of women with MS experience a relapse within the first three to four months postpartum, and that there are no interventions for effective prevention of this postpartum relapse. The existing research on the effects of breastfeeding on MS relapse is controversial and conflicting.

The authors explained in a press release that the effect of breastfeeding on postpartum MS relapse “seems to be plausible” because disease activity returned in the second half of the postpartum year in exclusively breastfeeding women. This connects to the introduction of supplemental feedings and the return of menstruation, the authors continued. By introducing formula and not breastfeeding exclusively, the researchers speculate, a woman’s hormonal status — including the return to ovulation – can resume balance.

“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,” the authors concluded. “Relapse in the first six months postpartum may be diminished by exclusive breastfeeding, but once regular feedings are introduced, disease activity is likely to return.”