And if she does not want to stop breastfeeding, she shouldn't.  Multiple
sclerosis is a disease that gets better and worse, and there is no evidence
that breastfeeding makes it worse and no reason to believe that it should.
There is some belief that pregnancy makes multiple sclerosis worse, but some
women go into remission during pregnancy.  One mother whom I am following is
nursing her second child who is 10 months old.  *Her* neurologist wants her
to keep breastfeeding, because she is never as well as when she has been
breastfeeding.  The same seemed true when she nursed her first child for 10
months, and she got worse when she weaned.  Or so it seemed.  I don't know
if this is really true.  Because multiple sclerosis is so unpredictable.

Whatever is true, we breastfeeding advocates are always being put on the
defensive by this type of situation.  This is exactly what is wrong in our
health system.  A specialist for this, a specialist for that, and nobody is
treating the *whole* person.  I am not so starry-eyed that I believe every
woman has had a marvelous experience with breastfeeding (although that is,
in many ways, the "system's" fault as well).  But many many women feel that
breastfeeding is one of the best things they have ever done.  Is it worth
taking this away from them on the *off chance* that their disease *might*
get a little better or *might* not get worse?  What if it were certain that
the disease was going to get worse while breastfeeding?  Is it still right
to take away from women what might be one of the best things they might
experience in their lives?

Let the neurologist bring the studies which prove that breastfeeding makes
multiple sclerosis worse.  But the mother decides about this, not the
neurologist.  It's her (and her partner's) call.  And the neurologist *has*
to respect that.

If I were a smoker (I'm not) and had emphysema, the physician would have
every right to advise me to stop smoking.  Since I am his patient, and there
is *no doubt* that smoking is an important cause of emphysema and does make
it worse, he has an obligation to give me this advice.  But if I say, "well,
I hear you, doc, but I don't want to stop smoking", well that's my decision,
and he must abide by it, and treat me in consequence.  Same with the
multiple sclerosis and breastfeeding, except that there is no proof that
breastfeeding makes it worse.

Jack Newman, MD, FRCPC