Last update Feb. 12, 2020

Maternal Multiple Sclerosis

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

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).


See below the information of these related products:

  • Alemtuzumab (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Azathioprine (Safe substance and/or breastfeeding is the best option.)
  • Cladribine (Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Commentary.)
  • Dimethyl Fumarate (Safe substance and/or breastfeeding is the best option.)
  • Fingolimod (Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.)
  • Glatiramer Acetate (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Interferon Beta (IFN-β) (Safe substance and/or breastfeeding is the best option.)
  • Methylprednisolone (Safe substance and/or breastfeeding is the best option.)
  • Mitoxantrone Hydrochloride (Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Commentary.)
  • Natalizumab (Safe substance and/or breastfeeding is the best option.)
  • Ocrelizumab (Safe substance and/or breastfeeding is the best option.)
  • Peginterferon beta-1a (Safe substance and/or breastfeeding is the best option.)
  • Prednisolone (Safe substance and/or breastfeeding is the best option.)
  • Prednisone (Safe substance and/or breastfeeding is the best option.)
  • Teriflunomide (Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Commentary.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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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Other names

Maternal Multiple Sclerosis is also known as


Group

Maternal Multiple Sclerosis belongs to this group or family:

References

  1. Freedman MS, Coyle PK, Hellwig K, Singer B, Wynn D, Weinstock-Guttman B, Markovic-Plese S, Galazka A, Dangond F, Korich J, Reder AT. Twenty Years of Subcutaneous Interferon-Beta-1a for Multiple Sclerosis: Contemporary Perspectives. Neurol Ther. 2024 Apr;13(2):283-322. Consulted on March 20, 2024 Abstract Full text (link to original source)
  2. Klehmet J, Begus-Nahrmann Y, Taipale K, Niemczyk G, Rehberg-Weber K. Pregnancy outcomes in female multiple sclerosis patients exposed to intramuscular interferon beta-1a or peginterferon beta-1a reported in a German Patient Support Programme - results from the non-interventional post-authorization safety study PRIMA. Ther Adv Neurol Disord. 2023 Dec 15;16:17562864231214041. Consulted on March 20, 2024 Abstract Full text (link to original source)
  3. Sánchez-Velasco S, Midaglia L, Vidal-Jordana A, Castillo F, Horno R, Carreras E, Serrano B, Bosch M, Agustí A, Montalban X, Tintoré M. Fármacos modificadores de la enfermedad en la esclerosis múltiple durante la lactancia: revisión de la evidencia actual. Rev Neurol. 2023 Jan 1;76(1):21-30. Abstract Full text (link to original source)
  4. Krysko KM, Dobson R, Alroughani R, Amato MP, Bove R, Ciplea AI, Fragoso Y, Houtchens M, Jokubaitis VG, Magyari M, Abdelnasser A, Padma V, Thiel S, Tintore M, Vukusic S, Hellwig K. Family planning considerations in people with multiple sclerosis. Lancet Neurol. 2023 Apr;22(4):350-366. Abstract
  5. Vidal-de Francisco D, Rosa-Garrido C, Ruiz-de Arcos M, Romero-Villarrubia A, Romero-Tellado M, Alonso-Torres AM, Delgado-Gil V, Agüera-Morales E, Díaz-Sánchez M, Piñar-Morales R, Muñoz-Fernández C, Pacheco-Cortegana EM, Durán-Ferreras E, Arnal-García MC, Mendibe-Bilbao MM, Rodríguez-Antigüedad A. Planificación familiar en hombres y mujeres con esclerosis múltiple. Análisis del Registro Andaluz (2018-2022). [Family planning in men and women with multiple sclerosis. Analysis of the Andalusian Registry (2018-2022)]. Rev Neurol. 2023 Jun 16;76(12):377-383. Abstract Full text (link to original source)
  6. Collorone S, Kodali S, Toosy AT. The protective role of breastfeeding in multiple sclerosis: Latest evidence and practical considerations. Front Neurol. 2023 Jan 24;13:1090133. Abstract Full text (link to original source)
  7. Langer-Gould AM. Pregnancy and Family Planning in Multiple Sclerosis. Continuum (Minneap Minn). 2019 Jun;25(3):773-792. Abstract
  8. Dobson R, Dassan P, Roberts M, Giovannoni G, Nelson-Piercy C, Brex PA. UK consensus on pregnancy in multiple sclerosis: 'Association of British Neurologists' guidelines. Pract Neurol. 2019 Apr;19(2):106-114. Abstract Full text (link to original source)
  9. 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
  10. 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
  11. Wei W, Liu L, Cheng ZL, Hu B. Increased plasma/serum levels of prolactin in multiple sclerosis: a meta-analysis. Postgrad Med. 2017 Abstract
  12. 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
  13. 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
  14. 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
  15. Almas S, Vance J, Baker T, Hale T. Management of Multiple Sclerosis in the Breastfeeding Mother. Mult Scler Int. 2016;2016:6527458. Abstract Full text (link to original source) Full text (in our servers)
  16. Fabian M. Pregnancy in the Setting of Multiple Sclerosis. Continuum (Minneap Minn). 2016 Abstract
  17. Bove R. Women's Issues in Multiple Sclerosis. Semin Neurol. 2016 Abstract
  18. 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)
  19. Strijbos E, Coenradie S, Touw DJ, Aerden L. High-dose methylprednisolone for multiple sclerosis during lactation: Concentrations in breast milk. Mult Scler. 2015 Abstract
  20. 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
  21. AEMPS. Informe de Posicionamiento Terapéutico de dimetilfumarato (Tecfidera). 2015 Full text (in our servers)
  22. Lawrence RM. Circumstances when breastfeeding is contraindicated. Pediatr Clin North Am. 2013 Feb;60(1):295-318. Abstract
  23. 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)
  24. Houtchens MK, Kolb CM. Multiple sclerosis and pregnancy: therapeutic considerations. J Neurol. 2013 Abstract
  25. 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)
  26. Tsui A, Lee MA. Multiple sclerosis and pregnancy. Curr Opin Obstet Gynecol. 2011 Abstract
  27. Argyriou AA, Makris N. Multiple sclerosis and reproductive risks in women. Reprod Sci. 2008 Abstract
  28. 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
  29. Ost L, Wettrell G, Björkhem I, Rane A. Prednisolone excretion in human milk. J Pediatr. 1985 Abstract
  30. 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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