New out on my MDLinx this morning:
http://archneur.ama-assn.org/cgi/content/full/2009.132v1
Exclusive Breastfeeding and the Risk of Postpartum Relapses in Women With
Multiple Sclerosis
Annette Langer-Gould, MD, PhD; Stella M. Huang, MS; Rohit Gupta; Amethyst D.
Leimpeter, MS; Eleni Greenwood; Kathleen B. Albers, MPH; Stephen K. Van Den
Eeden, PhD; Lorene M. Nelson, PhD
Arch Neurol. 2009;66(8):(doi:10.1001/archneurol.2009.132).
ABSTRACT
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.
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