Children Exposed to MS Drugs Through Breastfeeding Show No Developmental Harm

Monoclonal antibodies taken for multiple sclerosis (MS) while breastfeeding appears not to affect a child’s development during the first 3 years of life, according to results from a preliminary study to be presented in April at the American  Academy of Neurology annual meeting in Denver, Colorado.

“Most monoclonal antibody medications for multiple sclerosis are not currently approved for use while a mother is breastfeeding,” said study author Kerstin Hellwig, MD, of Ruhr University in Bochum, Germany. “Yet MS can develop during the childbearing years of life. Since the risk of MS relapses increases after giving birth, some mothers may need or want to restart these therapies, so it is important to determine whether these medications, through breast milk, have a negative impact on a child's development.”

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The study compared 183 infants whose mothers took monoclonal antibodies while breastfeeding with 183 infants, matched for exposure to monoclonal antibodies before or during pregnancy, whose mothers did not take the medications while breastfeeding. In each group, 180 mothers had MS, and 3 mothers had neuromyelitis optica spectrum disease, a rare demyelinating disease that specifically affects the optic nerve, spinal cord, or brain.

Researchers investigated the number of hospital stays, antibiotic use, developmental delays, and weight at follow-up visits over the first 3 years of the child’s life.

The study found no differences in the health or development of the children.

Among infants exposed to monoclonal antibodies during breastfeeding, 125 were exposed to natalizumab, 34 to ocrelizumab, 11 to rituximab, and 10 to ofatumumab, according to the study. Two were initially exposed to natalizumab, then to ocrelizumab. Another was first exposed to rituximab, then to ocrelizumab. The infants were breastfed for an average 5.5 months.

“Our data show infants exposed to these medications through breastfeeding experienced no negative effects on health or development within the first 3 years of life,” said Dr Hellwig.

The researcher noted that just a third of infants were followed for a full 3 years, making the results for the third year less meaningful than for the first 2 years.

Reference

Good news—MS drugs taken while breastfeeding may not affect child development. News release. American Academy of Neurology; March 4, 2024. Accessed March 22, 2024.