Women with multiple sclerosis had a 60% reduction in postpartum relapses when they breastfed exclusively for at least two months after giving birth ...
... Note that the study involved a small number of patients. Exclusive breastfeeding also was associated with a significantly later return of menses, and lactation-associated amenorrhea had a significant association with fewer postpartum relapses ...
"Our findings call into question the benefit of forgoing breastfeeding to start MS therapies and should be confirmed in a larger study," Annette Langer-Gould, M.D., Ph.D., of Stanford University, and colleagues concluded.
Immunomodulatory drugs used to treat MS are not recommended for use during pregnancy or lactation, and the effect of the drugs on postpartum relapses has never been studied. As a result, patients have to choose between nursing and resuming treatment, neither of which has clear supporting evidence, the authors said.
Previous studies of breastfeeding and postpartum relapse found little or no benefit, but none examined exclusive breastfeeding.
... The authors reported that 20 of 29 MS patients (69%) breastfed compared with 27 of 28 (96%) women in the control group. Eleven of 20 MS patients cited resumption of MS therapy as the primary reason for forgoing breastfeeding or early initiation of formula feeding.
A total of 14 of the 29 MS patients breastfed exclusively for at least two months postpartum, and five (36%) had postpartum relapses of MS. In contrast, 13 of the 15 (87%) women who did not breastfeed exclusively had one or more postpartum relapses.
The difference translated into an adjusted hazard ratio for relapse of 7.1 for women who did not breastfeed exclusively (95% CI 2.1 to 24.3, P=0.002).
... Median time to return of menses was 5.9 months postpartum with exclusive breastfeeding versus 2.2 months (P=0.001), and lactational amenorrhea significantly reduced the risk of MS relapse (P=0.01).
"Our findings suggest that women with MS should be encouraged to breastfeed exclusively for at least the first two months postpartum in lieu of starting immunomodulatory treatment shortly after deliver," the authors concluded.