From: Anne Smith, IBCLC (N.C.)
Subject:MS and BF
    This is my first post, so bear with me if I do something incorrectly (new
at this whole computer thing). I really need some help on this one.
     I'm working with a 28 year old mom who is expecting her first baby on
June 28. She was diagnosed with MS at age 19. She has gone through various
stages of remission/agressive progression/relapse since she was diagnosed. In
1992, she went through 5 days of steriod IV treatment and Betainterferon.
Since then, she has had relapses at approx. 6 month intervals, but has taken
no meds for the past 5 years.  Her pregnancy has been entirely uneventful,all
parameters normal.
     Her neurologist wants her to take Beta-interferon, Copaxion, and/or
Avonex. He told her that these would increase the intervals between relapses
and make them less severe if they occurred.  Since it well documented that
her chance of relapse is greater during the period 3-6 months postpartum, he
has advised her to go on the meds as soon as the baby is born, and
recommended that she not breastfeed.
      She says that the group of mds she worked with up north before moving
to NC several years ago were much less agressive about the use of
prophylactic treatment that the mds here.
      She wants to breastfeed and then see what happens. She says that if she
relapses, she will have to go on the meds indefinitely, as well as repeating
the 5 day steriod IV treatment. Since the treatment will be the same
regardless of whether she bfs or not, since bf is not known to cause an
exacerbation of symptoms,and because of the apparent protective effects
against MS in bf infants, she would very much like to nurse her baby, even if
only for a short time.
    Her neurologist says that she has been 'lucky' for five years, and is
strongly encouraging her to go on the meds and give up the idea of bf. She
wants to avoid the meds for as long as possible, but accepts that whe will at
some point need to take them.   Another reason for postponing treatment is
that she has been told that with repeated use, steroid treatment loses it
effectiveness.
    I can't find anything in  Briggs or Hale about the meds she mentioned.
Can anyone on the list provide me with any information to share with her, or
any links/articles on MS and bf? There is little in the standard literature.
    She is going to participate in a study re MS and breastfeeding mothers,
which will involve keeping a detailed bf journal. She couldn't remember the
name of the University involved, just that it was in NJ.
     Any info would be appreciated, especially feedback from mds re meds and
treatment protocols.





used no meds since then.

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