Influence of Infant Feeding Method on Postpartum Relapse of Mothers With MS

In an effort to determine relapse rates in breast-feeding and non—breast-feeding mothers with multiple sclerosis (MS) as well as differences in symptom prevalence between relapsing and non-relapsing mothers, weekly diaries through the first six postpartum months were kept by mothers to record the frequency and percentages of infant feeding by breast or formula and health problems that the mothers experienced. Of 140 mothers who breast-fed their infants, 35 (25%) experienced at least one neurologist-confirmed MS relapse during the first six months and 47 (33.6%) during the 12-month period; for non—breast-feeding mothers, 18 (51.4%) experienced relapse by six months and 22 (61.1%) by 12 months. MS relapse during pregnancy predicted increased relapse during the first three postpartum months while an increased percentage of infant feedings by breast predicted decreased relapse. Relapse the year before pregnancy and during pregnancy predicted increased relapse during the four- to six-month postpartum period. Length of time on immunomodulating therapy since delivery predicted increased relapse at seven to nine months. MS relapse during pregnancy predicted increased relapse at the 10- to 12- month period. For non—breast-feeding mothers none of the predictors of relapse were significant for the three-month period except use of immunomodulating therapy during the four- to six-month period when such use was associated with increased relapse. Relapsing compared with non-relapsing mothers reported significantly more MS-related symptoms during the three-month postpartum period. Decreased relapse rates during the first three months following delivery among breast-feeding mothers compared with non—breast-feeding mothers have implications for encouraging women with MS who wish to breast-feed their infants to do so, particularly if their pregnancy was free of relapse. Women with MS are also encouraged to postpone the initiation of immunomodulating therapy until three months following delivery or when breast-feeding is discontinued. (Int J MS Care. 2002; 4:183–191)