Takeaway
- Compared with peers who did not breastfeed, new mothers with multiple sclerosis (MS) who breastfed had a 37%-43% lower risk for relapse in the postpartum period.
Why this matters
- Up to 30% of women experience a postpartum relapse, and such relapse may worsen disability.
Key results
- Relative to nonbreastfeeding, breastfeeding conferred significant reduction in relapse risk (pooled summary OR, 0.63; P=.006).
- Findings are similar among the 4 studies reporting adjusted HR (aHR; pooled aHR, 0.57; P=.006).
- Analyses showed moderate heterogeneity attributable to variable prepregnancy relapse rate, postpartum follow-up duration, and publication year.
- Association was stronger:
- With higher prepregnancy annualized relapse rate (summary OR, 0.51; P=.002) vs lower prepregnancy annualized relapse rate (summary OR, 0.72; P=.24).
- With exclusive breastfeeding for ≥2 months (summary OR, 0.52; P=.04) vs any breastfeeding (summary OR, 0.68; P=.07).
Study design
- Systematic review of 24 cohort studies among 2974 women with relapsing-remitting MS, with meta-analysis of data from 16 studies.
- Main outcome: relapse in the postpartum period.
- Funding: Sylvia Lawry Physician Fellowship from National Multiple Sclerosis Society.
Limitations
- Lack of individual-patient data.
- Use of pooled ORs.
- Moderate heterogeneity.
- Inability to assess duration of breastfeeding that is beneficial.
References
References