Mothers with multiple sclerosis: Considerations for breastfeeding

During the congress of European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2021, Professor Kerstin Hellwig (Department of Neurology, Katholisches Klinikum Bochum, Germany) provided her expert insights on multiple sclerosis (MS) in pregnant and breastfeeding women. For many years, women with MS were discouraged from contemplating starting a family due to the perceived detrimental effect of pregnancy on this disease.¹ However, studies now indicate that the frequency of MS-associated relapses may decrease during pregnancy, with the most significant reduction in relapses observed during the third trimester.¹ Interestingly, an increase in MS relapses are likely to occur immediately post-partum, and these may be of a similar frequency to those observed prior to pregnancy.¹ Indeed, women with greater disease activity the year before pregnancy and during pregnancy are believed to have a higher risk of relapse 3 months post-partum.¹ Therefore, it is of interest to note that, in addition to a number of other benefits,² breastfeeding exclusively may be associated with a reduced risk of post-partum relapses, even in women with sub-optimally controlled MS prior to pregnancy.³