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5 Sept 2017

Can Breast-feeding Help Reduce MS Risk?



There's no disputing breast-feeding is a boon for both mom and her baby. Breast milk contains antibodies that fight off bacteria and viruses, lowers the risk of a baby developing asthma and allergies, and has even been linked to boosting a newborn's IQ. For moms, breast-feeding not only helps drop pregnancy pounds by burning extra calories, but it lowers the risk of breast and ovarian cancers, heart disease and Type 2 diabetes, and it also guards against osteoporosis. And that's not all. A new study reports that breast-feeding may also reduce a mom's risk of developing multiple sclerosis.

Multiple sclerosis is an autoimmune disease that targets the brain and spinal cord, stripping the myelin sheath from its axons (part of the nerve cell that transmits impulses). This damage leads to miscommunicated signals throughout the body and results in the accumulation of disabilities over time, including visual issues, problems with cognition, spasticity, extreme fatigue and loss of bowel and bladder function.



"These findings are particularly important because MS most often affects women of childbearing years," explains Dr. Annette Langer-Gould, regional physician multiple sclerosis champion at Kaiser Permanente Southern California in Pasadena. Langor-Gould is a cheerleader for breast-feeding and the lead author of a study published in the August 2017 issue of the journal Neurology which concludes that breast-feeding can lower a woman's risk of developing MS.

During the study, scientists looked at 397 women recently diagnosed with MS and 433 healthy women. Based on self-reporting questionnaires that covered contraceptives, pregnancy and breast-feeding, they found that women who breast-fed for 15 months or longer had a 53 percent less likely chance of developing MS, compared to women who did not breast-feed or who only nursed for four months or less.

But it turns out these findings aren't a slam-dunk. "First of all, the women were self-reporting which means that their responses might not be accurate. Many gave answers based on their memories of several years ago, and we know how skewed memories can be," says Dr. Rhonda Voskuhl, professor of UCLA's department of neurology and director of its multiple sclerosis program. "Also, the study relies on association, which means it's not a matter of cause and effect. On top of it, the research suggests women need to breast-feed for at least 15 months to reduce the MS risk. This time frame isn't realistic for most moms." (According to the National Association for Child Development, the average duration of breast-feeding in the U.S. is far shorter: three months.)



There's good news, too. "Even if a woman doesn't breast-feed or stops early, there are still benefits to pregnancy when it comes to MS," Voskuhl points out. Her UCLA research group conducted studies identifying estriol (a specific type of estrogen that is produced by the placenta and is only found in the body in appreciable quantities during pregnancy) as a hormone that offers protection against relapse in MS. The study was published in 2015 in The Lancet Neurology.

More recent follow-up research involving clinical trials of estriol supports Voskuhl's initial findings.

Langor-Gould acknowledges that questions remain whether the MS benefit stems from breast-feeding or pregnancy, but suggests that it's the lack of ovulation during breast-feeding (not hormones) that could play a role in the prevention of MS relapse. "The result of our study means there's evidence that women who are able to breast-feed their babies should be supported, and this includes moms who already have MS," she says.

What about the issue of breast-feeding and MS medications? Pregnant women are advised to stop taking many MS medications during pregnancy and resume after birth – unless they're breast-feeding. That's because some MS drugs (particularly DMD's – disease modifying drugs) are toxic for newborns and can be passed along through lactation. So here, too, there's no easy answer.

"Women who stop taking their MS medications while breast-feeding can start again once their baby has been weaned, and in most instances there won't be a relapse during this period," says Langor-Gould. In fact, a 2015 study published in JAMA Neurology supports her statement. The research showed evidence that mothers with multiple sclerosis who breast-fed their babies during the first two months after giving birth increased their chance of a six-month reprieve from MS relapse.

"If a woman wants to nurse, she should look for a doctor who supports her decision," Langor-Gould says. "What's more, there's no evidence showing that a woman who resumes her medication immediately after giving birth improves the overall course of her disease."



Voskuhl, however, isn't so quick to suggest that moms with MS forgo their meds in exchange for nursing their newborns and says that it should be individually decided between a patient and her doctor. "It's really a matter of how her disease was before pregnancy, how necessary the mom's DMD's were before she was pregnant and how she feels about the possibility of suffering a postpartum relapse," Voskuhl says. "You can't just assume breast-feeding is going to reduce relapses since it's already been shown that women with MS have a 20 to 30 percent chance of relapse within the first three to four months after delivery."

Clearly, more research is needed. In the meantime, there's no argument that it's a good idea for all women of childbearing age who are considering pregnancy and who have MS to discuss the pros and cons of breast-feeding with their physician.

Best Hospitals for Neurology & Neurosurgery
Rank Hospital Name Location

#1
Mayo Clinic Rochester, MN

#2
Johns Hopkins Hospital Baltimore, MD

#3
Massachusetts General Hospital Boston, MA

#4
New York-Presbyterian Hospital New York, NY

#5
UCSF Medical Center San Francisco, CA

#6
Cleveland Clinic Cleveland, OH

#7
Barnes-Jewish Hospital Saint Louis, MO

#8
University of Michigan Hospitals and Health Centers Ann Arbor, MI

#9
Northwestern Memorial Hospital Chicago, IL

#10
NYU Langone Medical Center New York, NY
Hospitals Ranking information as of September 5th, 2017

Tags: multiple sclerosis, autoimmune diseases, infants, patients, patient advice

Robin Westen is a freelance Health reporter at U.S. News. She’s an award-winning journalist who has written for numerous national magazines, including AARP Family Circle, Psychology Today, MORE, Health, Self, Parents, Glamour and Cosmopolitan, in addition to others. She has authored more than a dozen books on health and relationships, including “The Yoga-Body Cleanse,” “The Complete A to Z for Your V,” “Ten Days to Detox” and “808 Conversation Starters for Couples,” among others. Westen also won an Emmy for her writing on the ABC show “FYI.”

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