Breastfeeding in MS Care: A Win-Win for Mother & Child

Pregnancy and lactation present unique challenges and opportunities in the management of multiple sclerosis (MS). A major challenge is that postpartum relapse risk nearly doubles (20–40%) compared to preconception, especially as women may be advised to discontinue disease-modifying therapies (DMTs) during pregnancy. On the other hand, breastfeeding (BF), as a potential immunomodulatory opportunity, promotes an anti-inflammatory state and may reduce postpartum relapse risk by up to 43%, offering a protective strategy during this vulnerable period (secondary prevention). For newborns, BF supports long-term developmental programming and may reduce the risk of MS incidence (primary prevention) by shaping a healthy gut microbiome. Despite the innumerable benefits of BF for both mothers and children, lactating women often face a triple burden: managing their MS condition, caring for their newborns, and receiving insufficient educational support. Many new mothers report exacerbated fatigue, postpartum relapses and depression, conflicting medical advice, and persistent anxiety about their child’s future MS risk and medication safety. A critical unmet need exists for MS-focused antenatal education in regions where MS female population is high, early-life adversities are common, and exclusive BF rates remain low.