There is a genetic element to MS. Here we answer questions around family and MS, including questions about pregnancy and reducing your family’s risk of developing MS.
Siblings, parents and children of people with multiple sclerosis have an increased risk of MS.
Between 1 in 330 and 1 in 1000 people of the general population get MS, but the risk is 1 in 48 for a child of someone with MS, 1 in 37 for siblings and 1 in 5 for identical twins. We would recommend that family members make certain lifestyle changes to reduce their overall risk of developing MS, as genetics is only one risk factor.
In short, yes. In fact, step 6 of the program is Preventing Family Members from getting MS.
It will be easier for you to get others on board with your lifestyle changes and there is also an increased MS risk for people with a close relative who has MS. By making lifestyle changes, this risk can be reduced.
The areas of particular importance are; stopping smoking, eat a healthier diet and getting enough vitamin D through sunlight or supplementation. Vitamin D supplementation should start before birth – therefore vitamin D supplementation in pregnancy is imperative.
Diet for family members does not need to be strict– but consider encouraging a largely wholefood diet, with more plants and fish and less meat and dairy, and keep away from processed food.
We also encourage family members to take on elements of the program as they offer additional health benefits.
Note: Vitamin D supplementation recommendations are lower for people who haven’t got MS (5,000 IU a day supplement in winter)
It is a good idea to encourage your children to follow the OMS diet recommendations as well as ensuring that they are getting enough vitamin D.
There is good evidence that taking even a low dose of vitamin D regularly substantially reduces the risk of getting multiple sclerosis. Children of people with MS should routinely be supplemented with vitamin D.
Roy Swank noted in his study that there were no new cases of multiple sclerosis in families where everyone followed the same diet as those with MS. It is also easier to cook one meal only, but it may be difficult to get agreement from all family members, especially if they are older.
MS often affects those of childbearing age. This raises many questions around how MS and its treatments may affect pregnancy and vice versa.
- Pregnancy has a beneficial effect on MS, particularly during the last trimester. Women with MS can expect normal fertility and normal outcomes
- Pregnant women with MS have a 70% lower relapse rate than non-pregnant women with MS.
- Although relapse rates increase slightly in the three months after childbirth, only 28% of women who have given birth experience any relapse during this period.
- Breast-feeding for at least four months after delivery reduces by about 50% both a baby’s risk of developing MS and the mother’s risk of relapse
- Following the OMS Recovery Program during pregnancy is likely to reduce MS disease activity and progression, as well as the risk of pre-eclampsia, gestational diabetes, preterm delivery, and discomfort. A shorter labour is also likely
Medications are generally not tested on pregnant women, as it is unethical to expose the fetus to the potential risks. That said, there are medications that have not been shown to cause harm in many thousands of pregnancies, and therefore experience tells us they are safe. In terms of DMDs (disease-modifying drugs), the one currently licensed for use during pregnancy is Copaxone, but you should always discuss with your doctor before making any changes to your medication.Choosing whether or not to take a disease-modifying drug (DMD) can be a big decision to make for pregnant women who have MS.
Stress is closely linked to the development of MS and relapses, producing a negative effect not just on the mother but also on her developing baby. There’s evidence that stress can cause or increase the risk of diabetes, asthma, ADHD and autistic traits, cerebral palsy, miscarriage, preterm labor, malformations, and growth retardation.
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OMS advises mothers to eat a balanced diet rich in omega-3's, with vitamin D and folic acid supplementation. For more information – and specifics on how much fish is okay for an expectant mother.
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There is usually no risk to the pregnancy. The only involvement from the father in a pregnancy comes at the point of conception, so the DMD would have to affect the man’s sperm in order to impact on the baby. The only drug that has this effect is Aubagio (Terifluonmide), a pill which is used by people with RRMS. When taking this, a long washout period should be applied to get the DMD out of the man’s system before conception.
Check your vitamin D status urgently, and consider recommencing breastfeeding (if stopped). Low vitamin D is closely correlated with depression. If it is low, you will need the usual megadose to quickly get levels up. It is also important to get regular exercise, preferably outdoors, as this helps enormously with depression and will also help you get adequate vitamin D. It might be worth considering counselling.
Recent research confirms that breastfeeding is protective for the mother against further MS attacks while she is breastfeeding. Once you take a megadose, it will help your baby/ies get their vitamin D levels up (through the breast milk). That will reduce the risk of the children getting MS, and once they stop breastfeeding, vitamin D supplements should start as per the instructions found on this website.
In vitro fertilization (IVF) is associated with an increased relapse rate. Given that the hormonal changes of pregnancy affect MS, it is to be expected that the hormonal changes induced by IVF would affect the disease too. Studies have shown that GnRH (gonadotropin releasing hormone) may increase relapse rate, but GnRH antagonists do not.Given that the hormonal changes of pregnancy affect MS, it is to be expected that the hormonal changes induced by IVF would affect the disease too.
The effects are not good. Maternal diets high in saturated and trans-fats appear to contribute to early puberty, increased risk of breast cancer in offspring and their children, and increased anxiety in offspring. Studies show the food choices made in pregnancy can have a direct affect on the food choices of the offspring. Therefore if we choose to eat healthily our children are less likely to prefer unhealthy foods.Maternal diets high in saturated and trans-fats contribute to early puberty, increased risk of breast cancer in offspring and increased anxiety.