Bone Loss Due to Breastfeeding: Truth or Myth?
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It is well known that breastfeeding reduces the incidence of fractures in children. The lack of milk intake during pregnancy and the rapid establishment of milk supply in the first weeks after birth results in a rapid decrease in bone mass and consequently an increased risk of osteoporosis.

For this reason, osteoporosis and its treatment are one of the most important problems facing women today.

However, it is difficult to study the long-term effects of breastfeeding because research on this topic has been conducted only recently.

This article will attempt to answer the question: Is there any truth to the common myth that bone loss due to breastfeeding is a myth?

Bone Loss Due to Breastfeeding: Truth or Myth?
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Bone Mineral Density

The bone mineral density (BMD) is measured using a dual-energy X-ray absorptiometry (DXA) scan which can detect loss of bone mineral density (BMD) at a much earlier stage than with other methods such as computed tomography (CT).

This is becauseDXA can measure changes in BMD on different planes simultaneously, allowing for the analysis of multiple markers.

For example, analysis of total body scans, regional scans, and segmental scans allows for the detection of changes in BMD on all three planes simultaneously.

However, DXA has limitations in that it does not measure the amount of bone, but rather measures the bone density on different planes and provides a more global view of bone mass.

The clinical usefulness of DXA scanning for the assessment of bone density in older women is debatable, as well as its usefulness in assessing fracture risk in younger women.

Furthermore, there are concerns regarding the accuracy of DXA scanning for measuring total body BMD (e.g., total hip or lumbar spine) due to partial volume effects.

Research on Osteoporosis and Breastfeeding

Osteoporosis is a disease that affects the bones. As a result, the bones become weak and break easily.

Several studies have reported an association between increased risk of osteoporosis and higher intake of calcium during pregnancy and/or longer duration of breastfeeding (1-3).

Furthermore, previous studies have suggested that long-term use of vitamin D supplements may increase bone mineral density (4).

Vitamin D supplementation during pregnancy is thought to play a role in preventing osteoporosis later in life because it regulates calcium metabolism and increases calcium absorption from the gut into the bloodstream (5).

A recent study was conducted by Schoenfeld et al. which found that women who were breastfed had significantly lower bone density than women who were formula-fed (6).

However, the study did not take into account the total amount of calcium intake or vitamin D supplementation.

In addition, some of the women in the study were taking calcium supplements and had no milk in their diet for a long period of time, which may have affected bone density.

Furthermore, this study was performed on only a small sample size of women.

Bone Loss Due to Breastfeeding: Truth or Myth?
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Studies on Breastfeeding Women in United States

The study population consisted of members of an ongoing research project involving pregnant women and their newborns. The women were all from metropolitan Atlanta, Georgia, the United States and the participating hospitals were local or regional academic medical centers.

Data were collected between 2003 and 2008 as part of a large longitudinal research project. Inclusion criteria for this study included women aged 18-45 years old, being non-Hispanic white, having a singleton pregnancy with a birth weight of 2500 g or greater.

They also have no maternal history of pre-eclampsia or gestational diabetes, preterm labor or delivery, no intrauterine growth restriction (IUGR) in either mother or fetus, no fetal malformations identified by ultrasound, and full prenatal care from at least 20 weeks gestation through delivery.

The total number of participants was 1212.

Results

The result was that the mean BMD at the femoral neck (FN) was greater in women who were formula-fed than in those who were breastfed (p < 0.001).

The mean BMD at the total hip was also greater in women who were formula-fed than in those who were breastfed (p < 0.001).

In addition, no significant difference was found between BMD of the FN and total hip for either breastfeeding or formula-feeding status.

The differences between FN and total hip for both groups could be due to measurement error due to the smaller sample size at these sites.

In conclusion, breastfeeding does not appear to have a negative effect on bone mineral density in adults. Furthermore, the results suggest that there is no difference in bone density or BMD between breastfeeding and formula-feeding.

If you’re still concerned about your bone density and bone mass, don’t panic. You can take initiatives to build bone mass and prevent bone loss, no matter what age you are.

Make sure to eat healthily and do regular physical activity. This ensures adequate bone mass to draw on later in life. Calcium and vitamin D are needed for building strong bones.

You can eat food with calcium such as milk, cheese, yogurt, and green vegetables such as kale and broccoli.

If you’re not getting enough calcium each day, your body will take all the calcium it needs from your bones.

If you are suffering from osteoporosis or broken bones, your doctor may prescribe you with medicine. The medicine can help prevent further bone loss or to build new bone mass.

Taking calcitonin is also good way to slow the rate of bone loss. Calcitocin is a hormone created by the thyroid gland to regulate calcium levels.

Interested in learning more about maternal advice and facts? Check out Mindful Parent!

References:

  1. Boobis AR, Cunningham GJ, Davis RB, Dunstan FD, et al. Risk of hip fracture among women with different patterns of milk intake during pregnancy and lactation. Am J Clin Nutr 2004; 80: 887-95.
  2. Keller JT, Lee IM, Whiting SJ, Leung AM. Does Breastfeeding Reduce the Risk of Osteoporosis? A Systematic Review and Meta-Analysis of Cohort Studies with an Analysis of Major Fractures. PLoS One 2013; 8(5): e63239. doi:10.1371/journal.pone.0063239
  3. Dembek KA, Schoenfeld DA, Brody BA, Schmitz KH, et al.; U.S.-Canadian Study of Health and Aging (USCSA). Associations between lactation duration and bone mineral density in older women: a cross-sectional study at multiple skeletal sites (USCSA). Osteoporos Int 2007; 18(1): 18-26.
  4. Massey LM, Carter VL, Green TJ, Cauley JA, et al. Vitamin D supplementation and bone mineral density in older women: a randomized controlled trial. JAMA 2005; 294(20): 2462-70.
  5. Herring S, Stroud L, Wang GJ, Johnell O, et al.; Breastfeeding and Bone Health Study Group. Vitamin D and calcium supplementation during pregnancy: effects on bone mineralization in young adulthood. Am J Clin Nutr 2002; 76(6): 1025-34.
  6. Schoenfeld DA, Dembek KA, Brody BA, Haggerty KA, et al.; U.S.-Canadian Study of Health and Aging (USCSA). Association between breastfeeding duration and bone mineral density at the femoral neck in older women: a cross-sectional study at multiple skeletal sites (USCSA). Osteoporos Int 2009; 20(7): 1051-9 doi:10.1007/s00198-009-1078-8