Multiple sclerosis and breastfeeding

I am a Lactation Educator for preemie mothers and work in a NICU. I have a client with multiple sclerosis and I am having problems getting her to lactate. Could it be the multiple sclerosis? She's doing everything she is supposed to -- pumping every three hours, eating well, drinking fluids and on no meds right now.

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Multiple sclerosis (MS) is a neurological disorder affecting around 250,000 people in the United States. Average onset is generally between the years of 20 and 40, with women being affected at twice the rate as men.

MS causes symptoms that can be unpredictable. It can cause weakness, tremor, numbness, spastic movement, poor muscle coordination, loss of, or problems with vision, speech problems, and fatigue. Symptoms may be mild or severe.

While mothers with MS often experience a period of remission during their pregnancy, they may find their symptoms become worse during the first 3 months following their baby's birth. This has been found to be unaffected by breastfeeding (Nelson, 1988.)

This mom's difficulty with establishing lactation may have more to do with the fact that her baby was born prematurely, than with her MS. You didn't mention how early her baby was born.

Even very low birthweight babies can nurse at the breast, but in practice, the separation of the mother and her baby, can cause difficulties in establishing the breastfeeding relationship. Especially when the baby needs to be kept for quite a long time in the hospital NICU. Extended periods of expressing milk at home, while baby is fed by a bottle in the hospital, do not foster the beginning of breastfeeding, or help to establish a mom's milk supply. I would recommend that the mom and her baby be allowed and encouraged to spend a lot of time together. Is there a place at the hospital where they can get time alone to enjoy some cuddling (and lots of skin-to-skin contact?) The baby will benefit greatly from his mom's touch and all this closeness encourages him to spend some time at her breast.

For feeds missed (newborns nurse at least 8 to 12 times each day), this mother needs to express her milk with a hospital-grade electric breastpump, spending around 15 minutes when double pumping. I know this frequency of expression can be very difficult for mothers commuting back and forth between hospital and home.

Some other causes of insufficient milk supply following the birth are severe postpartum hemorrhage, retained placental fragment, hypothyroidism, untreated diabetes and anemia. Insufficient milk supply in this case could be due to a variety of factors, unrelated to the MS. See my letter, Insufficient milk supply, for more information.

Keep in mind that all is not lost if you and the mother are unable to turn this situation around, and bring back a full milk supply. If her baby is happy at her breast (a very important goal), a nursing supplementer can be used to provide the baby with the additional milk needed, while allowing both mom and baby to experience the joy of nursing. It's great this mother has your support. Best wishes in helping her to establish a good breastfeeding relationship with her new baby!

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