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Correspondence |

Breastfeeding and Multiple Sclerosis

Raffaele Iorio, MD; Viviana Nociti, MD; Giovanni Frisullo, MD, PhD; Agata Katia Patanella, MD; Pietro A. Tonali, MD; Anna Paola Batocchi, MD, PhD
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Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

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Arch Neurol. 2009;66(12):1580-1581. doi:10.1001/archneurol.2009.280
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We read with interest the article by Langer-Gould et al.1 Here we describe our related data from 23 pregnant women with clinically defined multiple sclerosis (MS) who had a 12-month postpartum follow-up of periodical neurological evaluation. Eight patients breastfed exclusively (BF group) (without formula feedings) for at least 2 months and 15 did not (NBF group). There were no significant differences in age (mean [SD] BF, 31.1 [3.9] vs NBF, 31.7 [3.7] years; P = .813), disease duration (mean [SD] BF, 39.6 [26.8] vs NBF, 71.5 [48.4] months; P = .114), prepregnancy immunomodulatory treatment (BF, 4 of 8; NBF, 12 of 15; P = .3108), or prepregnancy relapse rate (mean [SD] BF, 0.87 [0.64] vs NBF, 0.89 [0.71]; P = .9539) between the 2 groups.

No significant difference was found in the occurrence of postpartum relapses during the year following delivery between the BF (2 of 8 patients) and NBF groups (8 of 15 patients; P = .387). We also evaluated the development of new T2-weighted lesions on brain and spinal cord magnetic resonance imaging performed 1 year after delivery and did not find any significant difference between the 2 groups (BF, 4 of 8 vs NBF, 10 of 15; P = .740).

Kaplan-Meier analysis showed a tendency for the BF group to remain relapse free for a longer period; however, the difference did not reach statistical significance (Figure).

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Figure.

Kaplan-Meier curve for multiple sclerosis relapses in the postpartum period among women who did or did not breastfeed exclusively (P = .1846, log-rank test).

Grahic Jump Location

We know that our findings are not in agreement with the article by Langer-Gould et al, but previous studies on the effect of breastfeeding on MS relapses after delivery also did not show concordant results.2 3

In our opinion, larger studies are needed to better clarify the role of breastfeeding in the risk of postpartum relapses in patients with MS, and counseling regarding the advisability of breastfeeding should be based only on data from a large population to better define whether breastfeeding should be encouraged in women affected by MS.

AUTHOR INFORMATION

Correspondence: Dr Batocchi, Department of Neurosciences, Institute of Neurology, Catholic University, Largo Gemelli, 8 00168 Rome, Italy (annapaola.batocchi@rm.unicatt.it).

Financial Disclosure: None reported.

REFERENCES

Langer-Gould  A, Huang  SM, Gupta  R.  et al.  Exclusive breastfeeding and the risk of postpartum relapses in women with multiple sclerosis [published online ahead of print June 8, 2009]. Arch Neurol 2009;66 (8) 958- 963
PubMed
Nelson  LM, Franklin  GM, Jones  MC. Risk of multiple sclerosis exacerbation during pregnancy and breast-feeding. JAMA 1988;259 (23) 3441- 3443
PubMed
Gulick  EE, Halper  J. Influence of infant feeding method on postpartum relapse of mothers with MS. Int J MS Care 2002;4 (4) 4- 12

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Figure.

Kaplan-Meier curve for multiple sclerosis relapses in the postpartum period among women who did or did not breastfeed exclusively (P = .1846, log-rank test).

Grahic Jump Location

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Langer-Gould  A, Huang  SM, Gupta  R.  et al.  Exclusive breastfeeding and the risk of postpartum relapses in women with multiple sclerosis [published online ahead of print June 8, 2009]. Arch Neurol 2009;66 (8) 958- 963
PubMed
Nelson  LM, Franklin  GM, Jones  MC. Risk of multiple sclerosis exacerbation during pregnancy and breast-feeding. JAMA 1988;259 (23) 3441- 3443
PubMed
Gulick  EE, Halper  J. Influence of infant feeding method on postpartum relapse of mothers with MS. Int J MS Care 2002;4 (4) 4- 12

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