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Thursday, April 24, 2014
MG and breastfeeding
I would like to find out if mothers who have MG will pass on the antibodies to their infant via breastfeeding? If so then perhaps breastfeeding is not encouraged for mothers who are suffering from MG?
Also during pregnancy, i understand that the mother may pass on some of the antibodies to the baby. Will the baby in turn get MG as well? Thank you.
From the neurology side, I have never heard of myasthenia gravis conveyed to an infant via breast milk. I consulted with Dr. Sheela Geraghty (Medical Director, Center for Breast Feeding Medicine, Cincinnati Children's Hospital Medical Center) for her analysis. It is listed below:
Unfortunately, there have not been research studies done to definitively determine if breastfeeding increases the risk that infants born to mothers with Myasthenia Gravis will develop similar symptoms. However, we know that the absorption of many maternal antibodies through the infant gut wall is very low. This makes it unlikely, therefore, that the infant will ever develop symptoms from the contents of the breast milk.
What is more likely is that the infant will have received maternal antibodies trough the umbilical cord during pregnancy. These antibodies can potentially cause similar symptoms seen in adults. These symptoms are usually transitory, yet the baby will have to be watched closely for feeding difficulties in the early newborn period. Latching properly to the mother's breast to breastfeed takes considerable effort on the infant's part in order to transfer milk properly. Infants born to mothers with Myasthenia Gravis must be evaluated by a health care professional experienced in lactation management. The infant will have to be weighed frequently in the first few weeks of life to monitor the weight gain. In extreme cases the mother can be shown how to pump her milk if the baby needs a special feeding device or tube directly into the stomach for a short period of time. This way the baby can still get breast milk until he or she is ready to feed at the breast. A lactation consult can help the mother transition the baby to the breast at that time.
Finally, there are some medications that the mother may be taking during the postpartum period to help with Myasthenia Gravis symptoms which are contraindicated in breastfeeding. Every mother should let her health care provider know that she is breastfeeding. There are multiple resources available to help doctors determine which medications are safe while breastfeeding.
John G Quinlan, MD
Professor of Neurology
College of Medicine
University of Cincinnati