WEDNESDAY, July 6 (HealthDay News) -- Hopes that breast-feeding
can reduce flare-ups of multiple sclerosis have been dimmed by
recent research in Italy.
Researchers at the University of Florence found no support for
prior studies connecting breast-feeding with lower disease activity
for women with the degenerative nerve disorder commonly known as
Instead, they determined that women who were sicker tended not
to breast-feed, leading to the conclusion that some breast-feeding
mothers had fewer relapses simply because they were healthier.
"Breast-feeding should not be encouraged as a protective factor without an accurate evaluation of the specific patient characteristics," said Dr. Emilio Portaccio, lead author and neurologist in the university's department of neurology. "Our study is important due to a lack of a consensus on whether breast-feeding should be advised against in order to resume therapy soon after delivery."
Women with MS are cautioned not to take medications while
breast-feeding. The findings suggest that nursing may not be
possible for women "with high disease activity," said Portaccio.
Those women should be counseled that MS drug treatment soon after
delivery should be an option, the authors said.
Multiple sclerosis, a progressive autoimmune disorder
characterized by deterioration in physical coordination, affects
about 400,000 people in the United States. It strikes women twice
as often as men, with symptoms varying greatly from one person to
another, according to the National Multiple Sclerosis Society.
Typically, the disease goes into remission, sometimes for long
periods of time, and flare-ups during pregnancy are rare, according
to the society.
"The reason is not yet fully understood," said Portaccio.
But the effect of pregnancy on the course of the disease is "at
best neutral," Portaccio said, noting that other autoimmune disease
activity also declines while women are carrying children. During
that time, an immune system "switch" changes from a
"pro-inflammatory status to an anti-inflammatory status that
promptly reverts after delivery." Symptoms then increase to an
"even higher" level for a few months. Pregnancy is not believed to
cause any long-term worsening of the disorder, however.
Several drugs are used to fight MS, which attacks myelin, the
protective covering of nerve cells, causing inflammation. They are
not considered safe for use during pregnancy, however.
For their study, the researchers looked at 298 women with
full-term pregnancies from 2002 to 2008 at 21 MS treatment centers
throughout Italy. Of those, about 34 percent breast-fed their
babies for at least two months. The remaining mothers, who
breast-fed for zero to two months, were labeled the
Follow-up lasted for a year. After adjusting for factors such as
age and level of disability, the researchers found no significant
difference in relapse rates between the breast-feeding and
The only predictor of postpartum disease activity was the number
of relapses before and during pregnancy, the researchers found.
The study, published online July 6 in
Neurology, was conducted on behalf of the MS Study Group of the Italian Neurological Society.
The findings are "in line with what one might expect," said Dr.
Fred Lublin, a neurologist at Mount Sinai Medical Center in New
York City. "Healthier women tended to breast-feed."
The study "did not resolve the issue of breast-feeding," added
Lublin, who is also director of the Corinne Goldsmith Dickinson
Center for Multiple Sclerosis at Mount Sinai. "These studies are
all observational and it's hard to draw a conclusion of cause and
effect from an observational study." A controlled study is needed,
One expert expressed concern about the study's methodology. Dr.
Emmanuelle Waubant, a neurologist at the University of California
San Francisco Multiple Sclerosis Center, said that grouping women
who had breast-fed for less than two months with those who did not
breast-feed at all could have affected the findings.
"Breast-feeding affects hormone production," which could affect disease activity, said Waubant, who is also an associate professor of neurology at the university.
But Lublin, who did not share that concern, said the researchers
had used established criteria for group selection set by the World
To learn more about pregnancy and multiple sclerosis, visit the
National Multiple Sclerosis Society.