Despite previous research suggesting otherwise, breastfeeding does not appear to protect against multiple sclorosis (MS) relapses, according to a new study published in Neurology this week. Researchers in Italy found that the likelihood of relapse after pregnancy was tied to relapses before and during pregnancy but not to whether the mothers in their study breastfed or not. They concluded breastfeeding may not be a feasible option for mothers at high risk of relapse after pregnancy, because they may need to resume drug treatments straight away.

First author Dr Emilio Portaccio of the University of Florence, told the media that:

“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.”

“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,” he added.

Portaccio and colleagues conducted a prospective study of 298 women recruited from 21 Italian MS centers and followed up their pregnancies from 2002 to 2008. Over this time, 302 out of 423 pregnancies resulted in full-term delivery, and follow ups continued for at least one year after delivery.

34.4% of the mothers breastfed for at least two months after delivery, while the remaining 65.6% breastfed for less than this or not at all and were considered as not breastfeeding.

During the 12 months following delivery, 37% of the mothers had one relapse and 6.6% had two or more.

Portaccio and colleagues found that:

“The time-dependent profile of the relapse rate before, during, and after pregnancy did not differ between patients who breastfed and patients who did not.”

And in a multivariate analysis, a statistical tool where you can look at several measures at once to see which have the strongest influence on the outcome you are interested in (in this case relapse rate after pregnancy), they found that “the only significant predictors of postpartum relapses were relapses in the year before pregnancy … and during pregnancy”.

For relapses in the year before pregnancy they found the Hazard Ratio (HR) was 1.5 (with 95% Confidence Interval, CI, ranging from 1.3 to 1.9, p

Additional source : American Academy of Neurology.

Written by: Catharine Paddock, PhD