PMID- 19506118
OWN - NLM
STAT- MEDLINE
DCOM- 20090820
LR  - 20221102
IS  - 1538-3687 (Electronic)
IS  - 0003-9942 (Print)
IS  - 0003-9942 (Linking)
VI  - 66
IP  - 8
DP  - 2009 Aug
TI  - Exclusive breastfeeding and the risk of postpartum relapses in women with 
      multiple sclerosis.
PG  - 958-63
LID - 10.1001/archneurol.2009.132 [doi]
AB  - OBJECTIVE: To determine if exclusive breastfeeding protects against postpartum 
      relapses of multiple sclerosis (MS) and, if so, whether this protection is 
      related to prolonged lactational amenorrhea. DESIGN: We conducted structured 
      interviews to assess clinical, menstrual, and breastfeeding history during each 
      trimester and 2, 4, 6, 9, and 12 months postpartum and collected neurological 
      examination findings from the treating physicians of women with MS. Hazards 
      ratios (HRs) were adjusted for measures of disease severity and age. SETTING: 
      Kaiser Permanente Northern California and Stanford University. PARTICIPANTS: We 
      prospectively enrolled 32 pregnant women with MS and 29 age-matched, pregnant 
      controls. Main Outcome Measure Postpartum relapse. RESULTS: Of the 52% of women 
      with MS who did not breastfeed or began regular supplemental feedings within 2 
      months postpartum, 87% had a postpartum relapse, compared with 36% of the women 
      with MS who breastfed exclusively for at least 2 months postpartum (unadjusted 
      HR, 5.0; 95% confidence interval, 1.7-14.2; P = .003; adjusted HR, 7.1; 95% 
      confidence interval, 2.1-24.3; P = .002). Sixty percent reported that the primary 
      reason for foregoing exclusive breastfeeding was to resume MS therapies. Women 
      who breastfed exclusively had a later return of menses (P = .001) than women who 
      did not, and lactational amenorrhea was associated with a reduced risk of 
      postpartum relapses (P = .01). CONCLUSIONS: Our findings suggest that exclusive 
      breastfeeding and concomitant suppression of menses significantly reduce the risk 
      of postpartum relapses in MS. Our findings call into question the benefit of 
      foregoing breastfeeding to start MS therapies and should be confirmed in a larger 
      study.
FAU - Langer-Gould, Annette
AU  - Langer-Gould A
AD  - Stanford University School of Medicine, HRP Redwood Bldg, Room T202 MC 5405, 
      Stanford, CA 94305, USA. annette1@stanford.edu
FAU - Huang, Stella M
AU  - Huang SM
FAU - Gupta, Rohit
AU  - Gupta R
FAU - Leimpeter, Amethyst D
AU  - Leimpeter AD
FAU - Greenwood, Eleni
AU  - Greenwood E
FAU - Albers, Kathleen B
AU  - Albers KB
FAU - Van Den Eeden, Stephen K
AU  - Van Den Eeden SK
FAU - Nelson, Lorene M
AU  - Nelson LM
LA  - eng
GR  - K23 NS043207/NS/NINDS NIH HHS/United States
GR  - K23NS/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20090608
PL  - United States
TA  - Arch Neurol
JT  - Archives of neurology
JID - 0372436
SB  - IM
CIN - Arch Neurol. 2009 Dec;66(12):1580-1; author reply 1581. PMID: 20008670
CIN - Arch Neurol. 2009 Dec;66(12):1580; author reply 1581. PMID: 20008671
MH  - Breast Feeding/*adverse effects
MH  - Cohort Studies
MH  - Disability Evaluation
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Infant, Newborn
MH  - Kaplan-Meier Estimate
MH  - Multiple Sclerosis/diagnosis/*etiology
MH  - Pregnancy
MH  - Pregnancy Complications/diagnosis
MH  - Prospective Studies
MH  - Puerperal Disorders/*etiology
MH  - Recurrence
MH  - Risk
PMC - PMC9622216
MID - NIHMS1037685
EDAT- 2009/06/10 09:00
MHDA- 2009/08/21 09:00
PMCR- 2022/10/31
CRDT- 2009/06/10 09:00
PHST- 2009/06/10 09:00 [entrez]
PHST- 2009/06/10 09:00 [pubmed]
PHST- 2009/08/21 09:00 [medline]
PHST- 2022/10/31 00:00 [pmc-release]
AID - 2009.132 [pii]
AID - 10.1001/archneurol.2009.132 [doi]
PST - ppublish
SO  - Arch Neurol. 2009 Aug;66(8):958-63. doi: 10.1001/archneurol.2009.132. Epub 2009 
      Jun 8.