There have been conflicting results in the past about the role of exclusive breastfeeding, although studies have now suggested that exclusive breastfeeding is a modestly effective MS treatment with a natural end date that does not increase the risk of post-partum relapse [Hellwig et al, 2015]. Because DMTs for MS may enter breast milk, they are normally withheld during breastfeeding [Miller et al, 2014].
When patients receive high-dose corticosteroids, brief suspension of breastfeeding for 24–48 hours has also been recommended [Houtchens et al, 2013]. The decision whether to resume a DMT immediately following birth needs to be weighed against the potential benefits of breastfeeding. The choice of breastfeeding should be based on the prognostic factors of each individual patient i.e. after evaluating the risk of post-partum relapse, MS symptoms and the patient’s wish to restart their DMT [Hellwig et al, 2015].