Pregnancy and MS

Pregnancy and MS

Deciding whether to start or add to a family is often a complicated process, and MS raises a host of other questions to consider – the potential risks of medications before or during pregnancy, the effect of pregnancy on your MS, the possibility of your children getting MS and whether you’ll be able to breastfeed.

You may also have concerns/questions around how you’ll cope practically and emotionally living with MS whilst pregnant or later, with a baby and with children.

Common Questions

Can I pass MS on to my child?

Although MS has a genetic component, genes alone do not cause the condition, and the majority of children born to a parent with MS will not go on to develop MS.  Studies have shown that as few as 1.2% of people with MS have a parent with MS.

What is the impact of the pregnancy on my MS?

If you have relapsing remitting MS (RRMS), you’re less likely to have a relapse during pregnancy particularly in the last three months, although the risk of relapse does increase in the first three months after the birth of your baby. The individual patient’s experience with relapses following any previous pregnancy is a good indicator of the risk of relapse following the birth.

It’s thought that relapse rate is reduced during late pregnancy in part because of the effect of pregnancy hormones, notably oestrogen, which suppress the immune system to ensure that the body will carry a growing baby without rejecting it. There is also some indication that treatment with a Disease Modifying Therapy (DMT) for at least one year prior to conception, reduces the risk and severity of a relapse following birth of the baby.

Overall, relapse rate has been found to be similar during the pregnancy 12 months (nine months of pregnancy and three months following the birth) as in a non-pregnancy year. Additionally, research studies in the last five years suggest pregnancies in women with RRMS are associated with less long-term disability.

It’s difficult to predict the severity of any relapse that you might experience during pregnancy, but as far as is known, relapses don’t affect the baby. Tell your MS nurse or consultant if you do have a relapse, whether it’s severe or not.

There isn’t enough data on pregnancy in women with progressive MS to give an accurate indication of its effect on this type of multiple sclerosis.

Should I stop taking medication when trying to conceive?

There is no disease modifying drug  that has been proven to be completely safe during pregnancy. It is recommended that any woman who is taking a disease modifying drug treatment for MS, should seek guidance from her neurologist, if possible, prior to conception. This discussion will focus on what medication you are on and how active your MS is. Your neurologist will make recommendations as to changes needed prior to conception or may even recommend that you stay on the medication.

Can I take steroids whilst I’m pregnant?

Steroids carry some risks and so it’s thought that these should be avoided, particularly during the first three months of pregnancy when the foetus is developing very rapidly. However, if a severe relapse occurs, it may be decided – in consultation with your healthcare team – that the benefits outweigh any potential risks of treatment.

Questions For After Birth

What about breastfeeding?

How to feed a newborn baby is, and should be, a personal choice. You may have understandable concerns about breastfeeding. But MS cannot be passed through breast milk and studies on the course of MS suggest either no effect, or even a possible decrease in the relapse rate is associated with breastfeeding.

Because of the increased risk of relapse in the first few months after birth, it may be worth considering expressing and storing some breast milk. Additionally, stored milk can also be used by other members of the family to feed your baby, which allows you some extra rest time or a break from night feeds.

It’s good to discuss your feeding options with your MS nurse and/or midwife before your baby is born, so that they can provide appropriate support and advice. You may also access support and/or advice from the Australian Breastfeeding Association, who can put you in touch with other relevant services.

Can I take steroids when breastfeeding?

Steroids have been shown to cross into breast milk, but there is very little research that has explored the high doses used in treating MS relapse, so currently women are advised not to breastfeed whilst taking steroids.

You may choose to express as much milk as possible before starting the course of treatment and store this for use during the treatment – usually five days for oral steroids or three days if taken intravenously. Milk can be expressed and discarded during the actual treatment period to ensure you maintain your milk supply. Breastfeeding can start again between one and two days after the end of treatment – your MS nurse and neurologist will determine the exact timings with you.

When can I start MS medication after the birth?

Some disease modifying therapies can cross into breast milk, but there has not been a great deal of research in this area. Your healthcare provider will be able to advise on the most appropriate medication for your circumstances, however, if your MS is very active and you are at significant risk of relapse, you may choose to stop breastfeeding and opt for bottle feeding to enable you to recommence DMT.

The decision whether to resume disease modifying treatment immediately after the birth or not, needs to be considered against the advantages of breastfeeding.  A few things to consider:

  • You’re not protected by medications during the time when relapse is more likely to occur.
  • Exclusive breastfeeding has been shown to reduce after-birth relapses.
  • Fatigue is worse among women with MS, so breastfeeding may be less practical, especially as fatigue reduces milk protection.
  • Breast milk has been shown to protect against a range of diseases and illnesses in babies.

If you aren’t able, or don’t want, to breastfeed then you shouldn’t feel that you have in some way failed your child.

Considerations for MS symptoms

If you experience sensory disturbances in your hands, you should use a temperature monitor in the baby bath. For those who experience weakness in upper limbs – consider a baby sling to hold your baby.

If you experience fatigue and live in a two-level home, try to have a baby change mat, nappies, wipes, spare baby clothes etc. on each floor. And, as with any new parent, if possible sleep or rest when your baby does in the first few weeks and accept help when it’s offered!

Where do I go for more information?


There is support available to help you manage your MS:

  • Your GP/Midwife should be the first contact for any new questions related to pregnancy.
  • Your neurologist, MS Nurse or other healthcare provider can help you to manage your MS during pregnancy and discuss the best approach for your individual circumstances.

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