Exclusive breastfeeding and the risk of postpartum relapses in women with multiple sclerosis

  Introduction: Multiple Sclerosis (MS) is primarily a disease of women in their childbearing years. Risk for postpartum relapse is increased in the first 3 months after delivery. Previous studies of breastfeeding and postpartum relapse showed little or no benefit, but none examined exclusive breastfeeding. Methods: In this review article, electronic searches were undertaken in PubMed, Scholar Google and up to date since 2009. Results: Women with multiple sclerosis had a 60% reduction in postpartum relapses when they breastfed exclusively for at least two months after giving birth. Exclusive breastfeeding also was associated with a significantly later return of menses (P = .001), and lactation-associated amenorrhea had a significant association with fewer postpartum relapses. The 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 delivery. Conclusion: These findings highlight the need to critically evaluate the efficacy of early postpartum treatments in MS, especially if they are not compatible with lactation.