Studies in the past have reported an increased risk of exacerbations in multiple sclerosis during the postpartum period; it is not known whether breast-feeding alters this risk. We interviewed 435 women regarding pregnancy and breast-feeding history, providing for analysis 191 pregnancies that had occurred during a nonprogressive phase of the disease. The exacerbation rates during the nine-month postpartum period (34%) were more than three times the exacerbation rate during the nine months of pregnancy (10%). The exacerbation risk was highest in the three-month period following childbirth and appeared to stabilize after the sixth postpartum month. The exacerbation rates in breast-feeding and non—breast-feeding pregnancies were 38% and 31%, respectively. The average time to exacerbation was similar in breast-feeding (3.0 months) and non—breast-feeding (3.1 months) pregnancies. Although differential exacerbation rates during pregnancy and the postpartum period may be related to hormonal effects on the immune system, the hormonal effects of breast-feeding do not appear to similarly affect the risk of exacerbation.
Nelson LM, Franklin GM, Jones MC, Belendiuk G, Kasper B, Klatzman D, Mietlowski W, Solch S, Franklin G, Burks J, Nelson L, Wangaard C, McFarland H, Goodman A, Dale , Krebs H, Maloni H, Debronozo J, Labe , Traugott U, Aisen M, Robbins K, Sibley W, Laguna J, Laguna J, John , Cliford D, Smith L, Mclnnis J, Arnason B, Roos R, Reder A, Antel J, Aguis M, Martia R, Hurwitz B, Greenburg S, Fredane L, Herbstreith R, Hurwitz J, Johnson K, Panitch H, Koski CL, Fishman P, Haley S, Petajan J, Bray P, Rose J, Thurman D, Galster W, Tourtellotte W, Baumhefner RW, Ellison G, Myers L, Syndulko K, Newton L, Wolinsky J, Sears ES, Nath A, Weisbrodt C. Risk of Multiple Sclerosis Exacerbation During Pregnancy and Breast-feeding. JAMA. 1988;259(23):3441-3443. doi:10.1001/jama.1988.03720230051029