Casey from the MS community: Is it advisable to breastfeed after having a baby?
Nicola Macleod, MS Specialist Nurse: Yes, I think the answer to that is most definitely yes. Breastfeeding is, you know, classed as the best form of feeding for after the birth. I appreciate though that it largely is an individual choice on that, but I think you can’t get away from the fact that breastfeeding is the better option. I think it will depend though on individuals and whether or not, you know, if their MS was active, then you might want to consider going back on to a disease modifying therapy, but I think in general most people would support breastfeeding. The evidence as to whether or not breastfeeding would prevent a relapse isn’t quite there in my understanding, but I think it’s something that we should encourage generally, yeah.
Casey: And is it safe to take any form of DMT while you’re breastfeeding?
Nicola Macleod: I think you would have to look at the drug individually that you’re on before deciding that. I think as a general rule we would say no, but I think you would want to double-check that with your treating neurologist in the first instance.
Casey: Okay. And I suppose along the same lines, people with MS are often on other drugs to treat symptoms, where do they sit with breastfeeding, would you have to stop those as well?
Nicola Macleod: Yeah. Again, I think often the best person to sometimes ask about the drugs you’re taking for symptomatic relief, I think we sometimes forget those ones in our sort of eagerness to talk about disease modifying therapy, but yeah, absolutely. And I think that your general practitioner are often in good place to guide you on all of your other symptomatic drugs as well.
Nicola Macleod: Yeah. Or indeed, your obstetrician, and most hospital departments will have a foetal medicine team that will be able to look at all your other medicines and perhaps, you know, if you can’t get the right answers from your MS team or your GP, then, you know, some places will have specialist units that look at foetal medicine and be able to give you advice on drugs that you’re on.
Casey: Okay, great. So, aside from the DMTs and the systematic treatments that we talked about, what should I do if I’m taking any sort of over the counter medication, like supplements, for example?
Nicola Macleod: Yeah, I think with regards to supplements, obviously supplements don’t necessarily always appear on your medical records so, you know, your treating sort of doctors may not know these other things, and I think certainly, for example, vitamin D, a lot of people with MS will take vitamin D in slightly higher doses than the recommended daily allowance, and whilst vitamin D is recommended for pregnant women, I think there perhaps needs to be some sort of check on what dose people are taking, because there are so many varying dosages that people may take. And so I think, you know, before just carrying on with that dose, particularly if it is a higher dose than the recommended daily, you should check, you know, with your consultant or GP, should you be on that dose that’s not, that’s higher than recommended, just to be on the safe side. It’s definitely worth mentioning to the team.
Casey: Yeah, okay.