Last update: Feb. 12, 2020

Maternal Multiple Sclerosis

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

Multiple sclerosis (MS) affects 3 times more women than men during reproductive age (Bove 2016).

The longer breastfeeding lasts, the lower the risk of the mother developing multiple sclerosis (Langer 2017). Lower frequency of the disease has been observed in countries with higher frequency of breastfeeding (Dick 1976).

After pregnancy, there are more relapses in the first postpartum months (Fabian 2016).
For some authors, exclusive breastfeeding in women with MS lowers the risk of postpartum relapse (Langer 2017, Fabian 2016, Hellwig 2015 and 2012), while for others there is no link (Jesus 2017).

Not having been breastfed is associated with an increased risk of MS in pediatric age (Brenton 2017).

Mothers affected by MS need more breastfeeding support as they have been found to breastfeed less (Yalcin 2017).
Breastfeeding should be encouraged in patients with multiple sclerosis (Almas 2016, Hellwig 2015 and 2012,Lawrence 2013).

MS patients have increased levels of prolactin (Wei 2017).

Several medications used to treat MS are comptible with breastfeeding (Almas 2016, Hellwig 2012).

Corticosteroids are a safe therapeutic option during breastfeeding (Alroughani 2016).
Some authors advise a waiting period that varies between 4 hours (Alroughani 2016, Ost 1985), 8 hours (Strijbos 2015) and 24 hours (Houtchens 2013) to breastfeed after a corticosteroid megadose (Smets 2017).


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Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

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References

  1. Langer-Gould AM. Pregnancy and Family Planning in Multiple Sclerosis. Continuum (Minneap Minn). 2019 Jun;25(3):773-792. Abstract
  2. Yalcin SE, Yalcin Y, Yavuz A, Akkurt MO, Sezik M. Maternal and perinatal outcomes in pregnancies with multiple sclerosis: a case-control study. J Perinat Med. 2017 Abstract
  3. Brenton JN, Engel CE, Sohn MW, Goldman MD. Breastfeeding During Infancy Is Associated With a Lower Future Risk of Pediatric Multiple Sclerosis. Pediatr Neurol. 2017 Abstract
  4. Jesus-Ribeiro J, Correia I, Martins AI, Fonseca M, Marques I, Batista S, Nunes C, Macário C, Almeida MC, Sousa L. Pregnancy in Multiple Sclerosis: A Portuguese cohort study. Mult Scler Relat Disord. 2017 Abstract
  5. Langer-Gould A, Smith JB, Hellwig K, Gonzales E, Haraszti S, Koebnick C, Xiang A. Breastfeeding, ovulatory years, and risk of multiple sclerosis. Neurology. 2017 Abstract
  6. Smets I, Van Deun L, Bohyn C, van Pesch V, Vanopdenbosch L, Dive D, Bissay V, Dubois B; Belgian Study Group for Multiple Sclerosis.. Corticosteroids in the management of acute multiple sclerosis exacerbations. Acta Neurol Belg. 2017 Abstract
  7. Wei W, Liu L, Cheng ZL, Hu B. Increased plasma/serum levels of prolactin in multiple sclerosis: a meta-analysis. Postgrad Med. 2017 Abstract
  8. Bove R. Women's Issues in Multiple Sclerosis. Semin Neurol. 2016 Abstract
  9. Almas S, Vance J, Baker T, Hale T. Management of Multiple Sclerosis in the Breastfeeding Mother. Mult Scler Int. 2016 Abstract Full text (link to original source) Full text (in our servers)
  10. Alroughani R, Altintas A, Al Jumah M, Sahraian M, Alsharoqi I, AlTahan A, Daif A, Dahdaleh M, Deleu D, Fernandez O, Grigoriadis N, Inshasi J, Karabudak R, Taha K, Totolyan N, Yamout BI, Zakaria M, Bohlega S. Pregnancy and the Use of Disease-Modifying Therapies in Patients with Multiple Sclerosis: Benefits versus Risks. Mult Scler Int. 2016 Abstract Full text (link to original source) Full text (in our servers)
  11. Fabian M. Pregnancy in the Setting of Multiple Sclerosis. Continuum (Minneap Minn). 2016 Abstract
  12. Strijbos E, Coenradie S, Touw DJ, Aerden L. High-dose methylprednisolone for multiple sclerosis during lactation: Concentrations in breast milk. Mult Scler. 2015 Abstract
  13. Hellwig K, Rockhoff M, Herbstritt S, Borisow N, Haghikia A, Elias-Hamp B, Menck S, Gold R, Langer-Gould A. Exclusive Breastfeeding and the Effect on Postpartum Multiple Sclerosis Relapses. JAMA Neurol. 2015 Oct;72(10):1132-8. Abstract
  14. AEMPS. Informe de Posicionamiento Terapéutico de dimetilfumarato (Tecfidera). 2015 Full text (in our servers)
  15. Houtchens MK, Kolb CM. Multiple sclerosis and pregnancy: therapeutic considerations. J Neurol. 2013 Abstract
  16. Cree BA. Update on reproductive safety of current and emerging disease-modifying therapies for multiple sclerosis. Mult Scler. 2013 Jun;19(7):835-43. Abstract Full text (link to original source) Full text (in our servers)
  17. Lawrence RM. Circumstances when breastfeeding is contraindicated. Pediatr Clin North Am. 2013 Feb;60(1):295-318. Abstract
  18. Hellwig K, Haghikia A, Rockhoff M, Gold R. Multiple sclerosis and pregnancy: experience from a nationwide database in Germany. Ther Adv Neurol Disord. 2012 Sep;5(5):247-53. Abstract Full text (link to original source) Full text (in our servers)
  19. Tsui A, Lee MA. Multiple sclerosis and pregnancy. Curr Opin Obstet Gynecol. 2011 Abstract
  20. Argyriou AA, Makris N. Multiple sclerosis and reproductive risks in women. Reprod Sci. 2008 Abstract
  21. Coyle PK, Christie S, Fodor P, Fuchs K, Giesser B, Gutierrez A, Lynn J, Weinstock-Guttman B, Pardo L; Women Neurologists MS Initiative. Multiple sclerosis gender issues: clinical practices of women neurologists. Mult Scler. 2004 Abstract
  22. Ost L, Wettrell G, Björkhem I, Rane A. Prednisolone excretion in human milk. J Pediatr. 1985 Abstract
  23. Dick G. President's address. The etiology of multiple sclerosis. Proc R Soc Med. 1976 Aug;69(8):611-5. Abstract Full text (link to original source) Full text (in our servers)

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