Breastfeeding
Many new mothers with MS are concerned about the potential for postpartum relapses. Whether exclusive breastfeeding could mitigate this risk is debated [1,2].
Until 2019, new mothers with MS have had to decide between nursing and resuming treatment. The decision is often made on the basis of MS activity before and after pregnancy [1-4]. While mothers with stable disease have seemed to lean towards breastfeeding, those with active disease have been more likely to restart MS therapy early after delivery and refrain from breastfeeding [5,6]. The reduction in postpartum relapses observed in contemporary cohorts may be a result of this approach [7,8].
As of 2019, new mothers have more options: interferon beta therapies like BETAFERON can be taken while breastfeeding, with limited information available on the transfer of BETAFERON into human milk [9].
According to the BETAFERON European Summary of Product Characteristics, limited information available on the transfer of interferon beta-1b into breast milk, together with the chemical / physiological characteristics of interferon beta, suggests that levels of interferon beta-1b excreted in human milk are negligible. No harmful effects on the breastfed newborn/infant are anticipated. BETFAERON can be used during breast-feeding [9].
In a small study (n=6), the relative infant dose was estimated to be only 0.006% of the maternal dose (data generated with intramuscular interferon beta-1a) [10,11]. Furthermore, any trace amounts ingested by the infant would likely be depolymerized in the gastrointestinal tract [3].
Evaluation of data from the German MS and Pregnancy Registry found no negative influences on growth or development in infants (n=74) whose mothers (n=69) breastfed under interferon beta (n=39), glatiramer acetate (n=34) or both (n=1)* [12]. The median duration of interferon beta-exposed breastfeeding was 8.5 months, with a very wide range of 0.5–28.5 months. Markers of child well-being and development (body weight, body length, head circumference, motor and language development, number of hospitalizations or antibiotic use) were consistent with national averages [12].
BETAFERON and breastfeeding
Excerpt from the European SmPC
Prof. Dr. Bassem Yamout
MS, therapy and breastfeeding
References
- Portaccio E, Amato MP. Mult Scler J 2019; 25(9): 1211-6. Return to content
- Dobson R, Mowry EM. Neurology 2020; 94(18): 769-70. Return to content
- Coyle PK. Ther Adv Neurol Disord 2016; 9(3): 198-210. Return to content
- Hughes SE et al. Mult Scler 2014; 20(6): 739-46. Return to content
- Airas L et al. Neurology 2010; 75(5): 474-6. Return to content
- Houtchens MK et al. Neurology 2018; 91(17): e1559-69. Return to content
- Langer-Gould A et al. Neurology 2020; 94(18): e1939-e1949. Return to content
- Bsteh G et al. Mult Scler 2020; 26(1): 69-78. Return to content
- BETAFERON European Summary of Product Characteristics, October 2020. Available at: https://www.ema.europa.eu/en/documents/product-information/betaferon-epar-product-information_en.pdf Return to content
- Almas S et al. Mult Scler Int 2016; 2016: 6527458. Return to content
- Hale TW et al. Breastfeed Med 2012; 7(2): 123-5. Return to content
- Ciplea AI et al. Neurol Neuroimmunol Neuroinflamm 2020; 7: e757 Return to content
