Neurológia pre prax 3/2022

Breastfeeding and multiple sclerosis

Multiple sclerosis (MS) is a chronic autoimmune and neurodegenerative disease affecting the brain and spinal cord. Most often the disease begins between the ages of 20–30 and occurs three times as often in women. Treatment is initiated early, preferably after the first symptom of the disease. In patients of childbearing age, it is advisable to choose a drug that is safe after conception. The period of pregnancy has a favourable effect on the course of the disease, with a decrease in activity in most cases. In stable patients, therapy is discontinued. If patients have unplanned pregnancy and the disease is not stable, therapy with certain drugs can be continued. This communication gives an overview of the drugs that can be given not only during pregnancy but also during lactation. The procedures used in the care of women after childbirth and during lactation are mentioned. Stabilized patients are assured of safe therapy during this time and can continue breastfeeding for 4–6 months. Other drugs from both the first and escalation lines do not yet have a proven safety profile during pregnancy or lactation and are therefore not mentioned in the article.

Keywords: multiple sclerosis, pregnancy, breastfeeding, interferon‑beta, glatiramer acetate, exclusive breastfeeding, relapse, methylprednisolone