{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:56:17Z","timestamp":1770746177837,"version":"3.49.0"},"reference-count":50,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100009945","name":"Merck KGaA","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009945","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","msard-journal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis and Related Disorders"],"published-print":{"date-parts":[[2021,5]]},"DOI":"10.1016\/j.msard.2021.102812","type":"journal-article","created":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T21:50:21Z","timestamp":1612561821000},"page":"102812","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"special_numbering":"C","title":["Shared breastfeeding &amp; other early multiple sclerosis risk factors: A case-control study"],"prefix":"10.1016","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1992-0654","authenticated-orcid":false,"given":"Nuha M.","family":"Alkhawajah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laith","family":"Hussain-Alkhateeb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4603-7752","authenticated-orcid":false,"given":"Yafa A.","family":"Alshamlan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Osama","family":"Almohaini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghadah A.","family":"Aleissa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3044-641X","authenticated-orcid":false,"given":"Taim A.","family":"Muayqil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0138-7924","authenticated-orcid":false,"given":"Salman","family":"Aljarallah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.msard.2021.102812_bib0014","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1007\/s10072-017-3080-9","article-title":"Multiple sclerosis and environmental risk factors: a case-control study in Iran","volume":"38","author":"Abbasi","year":"2017","journal-title":"Neurol Sci"},{"key":"10.1016\/j.msard.2021.102812_bib0040","first-page":"530","volume":"3","author":"Abdul Salam","year":"2014"},{"key":"10.1016\/j.msard.2021.102812_bib0045","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1007\/s10654-009-9367-2","article-title":"A population-based case\u2013control study on viral infections and vaccinations and subsequent multiple sclerosis risk","volume":"24","author":"Ahlgren","year":"2009","journal-title":"Eur J Epidemiol"},{"key":"10.1016\/j.msard.2021.102812_bib0023","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1159\/000341240","article-title":"Risk Factors for Multiple Sclerosis in Kuwait: A Population-Based Case-Control Study","volume":"40","author":"Al-Afasy","year":"2013","journal-title":"Neuroepidemiology"},{"key":"10.1016\/j.msard.2021.102812_bib0037","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/j.1600-0404.1981.tb00757.x","article-title":"Birth order and risk of multiple sclerosis: are they associated and how?","volume":"63","author":"Alperovitch","year":"1981","journal-title":"Acta Neurol Scand"},{"key":"10.1016\/j.msard.2021.102812_bib0033","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.4081\/pr.2013.e6","article-title":"Impact of maternal vitamin D status during pregnancy on the prevalence of neonatal vitamin D deficiency","volume":"5","author":"Aly","year":"2013","journal-title":"Pediatr Rep"},{"key":"10.1016\/j.msard.2021.102812_bib0027","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1056\/NEJMra020100","article-title":"The Effect of Infections on Susceptibility to Autoimmune and Allergic Diseases","volume":"347","author":"Bach","year":"2002","journal-title":"N Engl J Med"},{"key":"10.1016\/j.msard.2021.102812_bib0026","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1093\/aje\/kwj148","article-title":"Sibship Characteristics and Risk of Multiple Sclerosis: A Nationwide Cohort Study in Denmark","volume":"163","author":"Bager","year":"2006","journal-title":"American Journal of Epidemiology"},{"key":"10.1016\/j.msard.2021.102812_bib0028","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S1474-4422(14)70267-4","article-title":"Environmental risk factors and multiple sclerosis: an umbrella review of systematic reviews and meta-analyses","volume":"14","author":"Belbasis","year":"2015","journal-title":"The Lancet Neurology"},{"key":"10.1016\/j.msard.2021.102812_bib0015","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/j.1600-0404.1989.tb03841.x","article-title":"Risk factors in multiple sclerosis: a population-based case-control study in Hautes-Pyr\u00e9n\u00e9es, France","volume":"80","author":"Berr","year":"1989","journal-title":"Acta Neurologica Scandinavica"},{"key":"10.1016\/j.msard.2021.102812_bib0021","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1177\/1352458514557305","article-title":"High inbreeding in the Faroe Islands does not appear to constitute a risk factor for multiple sclerosis","volume":"21","author":"Binzer","year":"2015","journal-title":"Mult Scler"},{"key":"10.1016\/j.msard.2021.102812_bib0004","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1034\/j.1399-0004.2001.600201.x","article-title":"Consanguinity and its relevance to clinical genetics","volume":"60","author":"Bittles","year":"2001","journal-title":"Clin Genet"},{"key":"10.1016\/j.msard.2021.102812_bib0012","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.pediatrneurol.2017.09.007","article-title":"Breastfeeding During Infancy Is Associated With a Lower Future Risk of Pediatric Multiple Sclerosis","volume":"77","author":"Brenton","year":"2017","journal-title":"Pediatric Neurology"},{"key":"10.1016\/j.msard.2021.102812_bib0047","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1177\/135245850000600211","article-title":"Multiple sclerosis and tonsillectomy: no evidence for an influence on the development of disease or clinical phenotype","volume":"6","author":"Broadley","year":"2000","journal-title":"Mult Scler"},{"key":"10.1016\/j.msard.2021.102812_bib0042","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1093\/oxfordjournals.aje.a113062","article-title":"EPSTEIN-BARR VIRUS INFECTIONS IN A NURSERY","volume":"113","author":"Chang","year":"1981","journal-title":"American Journal of Epidemiology."},{"key":"10.1016\/j.msard.2021.102812_bib0001","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1016\/S0140-6736(02)08220-X","article-title":"Multiple sclerosis","volume":"359","author":"Compston","year":"2002","journal-title":"The Lancet"},{"key":"10.1016\/j.msard.2021.102812_bib0039","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1186\/1471-2377-11-123","article-title":"Environmental factors in early childhood are associated with multiple sclerosis: a case-control study","volume":"11","author":"Conradi","year":"2011","journal-title":"BMC Neurol"},{"key":"10.1016\/j.msard.2021.102812_bib0020","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1212\/WNL.56.6.784","article-title":"Recurrence risks to sibs of MS index cases: Impact of consanguineous matings","volume":"56","author":"Dessa Sadovnick","year":"2001","journal-title":"Neurology"},{"key":"10.1016\/j.msard.2021.102812_bib0041","unstructured":"Duffin E. Average size of a family in the US 1960-2019. In: Statista [online]. Available at: www.Statista.com. Accessed August 28, 2020."},{"key":"10.1016\/j.msard.2021.102812_bib0049","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1097\/EDE.0b013e31819ed4b9","article-title":"Prenatal and Perinatal Factors and Risk of Multiple Sclerosis","volume":"20","author":"Gardener","year":"2009","journal-title":"Epidemiology"},{"key":"10.1016\/j.msard.2021.102812_bib0050","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.msard.2017.02.004","article-title":"Maternal and perinatal characteristics of infants who, later in life, developed multiple sclerosis: Record-linkage study","volume":"13","author":"Goldacre","year":"2017","journal-title":"Multiple Sclerosis and Related Disorders"},{"key":"10.1016\/j.msard.2021.102812_bib0029","doi-asserted-by":"crossref","first-page":"373","DOI":"10.4103\/1673-5374.245462","article-title":"The role of Epstein-Barr virus in multiple sclerosis: from molecular pathophysiology to in vivo imaging","volume":"14","author":"Guan","year":"2019","journal-title":"Neural Regen Res"},{"key":"10.1016\/j.msard.2021.102812_bib0046","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1186\/s12883-014-0196-x","article-title":"Environmental exposures and the risk of multiple sclerosis investigated in a Norwegian case-control study","volume":"14","author":"Gustavsen","year":"2014","journal-title":"BMC Neurol"},{"key":"10.1016\/j.msard.2021.102812_bib0018","doi-asserted-by":"crossref","DOI":"10.1177\/2055217320928101","article-title":"Breastfeeding is associated with reduced risk of multiple sclerosis in males, predominantly among HLA-DRB1*15:01 carriers","volume":"6","author":"Hedstr\u00f6m","year":"2020","journal-title":"Multiple Sclerosis Journal - Experimental, Translational and Clinical."},{"key":"10.1016\/j.msard.2021.102812_bib0017","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1542\/peds.2015-1669","article-title":"Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial","volume":"136","author":"Hollis","year":"2015","journal-title":"PEDIATRICS"},{"key":"10.1016\/j.msard.2021.102812_bib0008","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1002\/(SICI)1097-0258(19980730)17:14<1623::AID-SIM871>3.0.CO;2-S","article-title":"A simple method of sample size calculation for linear and logistic regression","volume":"17","author":"Hsieh","year":"1998","journal-title":"Stat Med"},{"key":"10.1016\/j.msard.2021.102812_bib0025","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1038\/ng.3395","article-title":"the International Multiple Sclerosis Genetics Consortium. Class II HLA interactions modulate genetic risk for multiple sclerosis","volume":"47","year":"2015","journal-title":"Nat Genet"},{"key":"10.1016\/j.msard.2021.102812_bib0003","first-page":"203","article-title":"Breastfeeding, the immune response, and long-term health","volume":"106","author":"Jackson","year":"2006","journal-title":"J Am Osteopath Assoc"},{"key":"10.1016\/j.msard.2021.102812_bib0007","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1177\/1352458510390406","article-title":"Familial multiple sclerosis: does consanguinity have a role?","volume":"17","author":"Jumah","year":"2011","journal-title":"Mult Scler"},{"key":"10.1016\/j.msard.2021.102812_bib0019","doi-asserted-by":"crossref","DOI":"10.1177\/2055217319881775","article-title":"Naser Moghadasi A. Multiple sclerosis and human leukocyte antigen genotypes: Focus on the Middle East and North Africa region","volume":"6","author":"Maghbooli","year":"2020","journal-title":"Multiple Sclerosis Journal - Experimental, Translational and Clinical."},{"key":"10.1016\/j.msard.2021.102812_bib0024","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.msard.2016.09.013","article-title":"Consanguinity and multiple sclerosis susceptibility: A case control study","volume":"10","author":"Maghzi","year":"2016","journal-title":"Multiple Sclerosis and Related Disorders"},{"key":"10.1016\/j.msard.2021.102812_bib0048","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1007\/s00415-016-8263-4","article-title":"Vaccines and multiple sclerosis: a systematic review","volume":"264","author":"Mailand","year":"2017","journal-title":"J Neurol"},{"key":"10.1016\/j.msard.2021.102812_bib0022","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1038\/ejhg.2011.170","article-title":"Genome-wide homozygosity and multiple sclerosis in Orkney and Shetland Islanders","volume":"20","author":"McWhirter","year":"2012","journal-title":"Eur J Hum Genet"},{"key":"10.1016\/j.msard.2021.102812_bib0036","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1097\/01.ede.0000142138.46167.69","article-title":"Parental Age, Family Size, and Risk of Multiple Sclerosis","volume":"15","author":"Montgomery","year":"2004","journal-title":"Epidemiology"},{"key":"10.1016\/j.msard.2021.102812_bib0009","doi-asserted-by":"crossref","first-page":"e12567","DOI":"10.1111\/mcn.12567","article-title":"Awareness and prevalence of human milk sharing and selling in the United States","volume":"14","author":"O'Sullivan","year":"2018","journal-title":"Matern Child Nutr"},{"key":"10.1016\/j.msard.2021.102812_bib0002","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/mcn.12221","article-title":"Human milk sharing practices in the U.S.: Human milk sharing in the U.S.","volume":"12","author":"Palmquist","year":"2016","journal-title":"Matern Child Nutr"},{"key":"10.1016\/j.msard.2021.102812_bib0032","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1001\/jama.293.4.463","article-title":"Exposure to Infant Siblings During Early Life and Risk of Multiple Sclerosis","volume":"293","author":"Ponsonby","year":"2005","journal-title":"JAMA"},{"key":"10.1016\/j.msard.2021.102812_bib0038","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.1469-1809.1951.tb02458.x","article-title":"THE FAMILIAL OCCURRENCE OF DISSEMINATED SCLEROSIS","volume":"16","author":"Pratt","year":"1951","journal-title":"Annals of Eugenics"},{"key":"10.1016\/j.msard.2021.102812_bib0013","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1007\/s00415-015-7704-9","article-title":"Reduced duration of breastfeeding is associated with a higher risk of multiple sclerosis in both Italian and Norwegian adult males: the EnvIMS study","volume":"262","author":"Ragnedda","year":"2015","journal-title":"J Neurol"},{"key":"10.1016\/j.msard.2021.102812_bib0006","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1212\/01.wnl.0000438216.93319.ab","article-title":"Effects of Bacille Calmette-Guerin after the first demyelinating event in the CNS","volume":"82","author":"Ristori","year":"2014","journal-title":"Neurology"},{"key":"10.1016\/j.msard.2021.102812_bib0030","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1093\/ije\/dyu118","article-title":"Sibship structure and risk of infectious mononucleosis: a population-based cohort study","volume":"43","author":"Rostgaard","year":"2014","journal-title":"International Journal of Epidemiology"},{"key":"10.1016\/j.msard.2021.102812_bib0031","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/S1474-4422(05)70170-8","article-title":"Multiple sclerosis and birth order: a longitudinal cohort study","volume":"4","author":"Sadovnick","year":"2005","journal-title":"The Lancet Neurology"},{"key":"10.1016\/j.msard.2021.102812_bib0016","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1159\/000110705","article-title":"Breast-Feeding and Multiple Sclerosis","volume":"1","author":"Spencely","year":"1982","journal-title":"Neuroepidemiology"},{"key":"10.1016\/j.msard.2021.102812_bib0011","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1038\/s41586-018-0617-x","article-title":"Temporal development of the gut microbiome in early childhood from the TEDDY study","volume":"562","author":"Stewart","year":"2018","journal-title":"Nature"},{"key":"10.1016\/j.msard.2021.102812_bib0043","doi-asserted-by":"crossref","first-page":"790","DOI":"10.3109\/02770903.2011.604884","article-title":"Early Daycare Attendance Increase the Risk for Respiratory Infections and Asthma of Children","volume":"48","author":"Sun","year":"2011","journal-title":"Journal of Asthma"},{"key":"10.1016\/j.msard.2021.102812_bib0034","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1007\/s10995-011-0866-x","article-title":"Breastfeeding Practices Among First-Time Mothers and Across Multiple Pregnancies","volume":"16","author":"Sutherland","year":"2012","journal-title":"Matern Child Health J"},{"key":"10.1016\/j.msard.2021.102812_bib0005","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/1742-4755-6-17","article-title":"Consanguinity and reproductive health among Arabs","volume":"6","author":"Tadmouri","year":"2009","journal-title":"Reprod Health"},{"key":"10.1016\/j.msard.2021.102812_bib0010","doi-asserted-by":"crossref","first-page":"16396","DOI":"10.1038\/s41598-019-52894-z","article-title":"Gut microbiome of treatment-na\u00efve MS patients of different ethnicities early in disease course","volume":"9","author":"Ventura","year":"2019","journal-title":"Sci Rep"},{"key":"10.1016\/j.msard.2021.102812_bib0035","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/7474192","article-title":"Maternal-Cord Blood Vitamin D Correlations Vary by Maternal Levels","volume":"2016","author":"Wegienka","year":"2016","journal-title":"Journal of Pregnancy"},{"key":"10.1016\/j.msard.2021.102812_bib0044","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/ane.12844","article-title":"Is the hygiene hypothesis relevant for the risk of multiple sclerosis?","volume":"136","author":"Wendel-Haga","year":"2017","journal-title":"Acta Neurol Scand"}],"container-title":["Multiple Sclerosis and Related Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S221103482100078X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S221103482100078X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T08:54:57Z","timestamp":1761900897000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S221103482100078X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":50,"alternative-id":["S221103482100078X"],"URL":"https:\/\/doi.org\/10.1016\/j.msard.2021.102812","relation":{},"ISSN":["2211-0348"],"issn-type":[{"value":"2211-0348","type":"print"}],"subject":[],"published":{"date-parts":[[2021,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Shared breastfeeding & other early multiple sclerosis risk factors: A case-control study","name":"articletitle","label":"Article Title"},{"value":"Multiple Sclerosis and Related Disorders","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.msard.2021.102812","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}],"article-number":"102812"}}