Last update Dec. 30, 2022

Maternal osteoporosis

Compatible

Safe product and/or breastfeeding is the best option.

Breatfeeding is associated with transient bone loss, with full recovery of bone mineral density (BMD) within 6 - 12 months after weaning, which minimizes any significant damage to the maternal skeleton. (Capozzi 2021, Oboh 2021, Grizzo 2020, Sowers 1993)

The relationship between breastfeeding and its duration with osteoporosis and the risk of postmenopausal fracture (hip or others) is highly controversial, since while:

  • there are authors and systematic reviews that do not find any association, (Bakker 2020, Yan 2019, Abou 2018, Crandall 2017, Mori 2015, Chowdhury 2015, Lebel 2014, Kovacs 2014, Yumusakhuylu 2013, Lenora 2009, Ip 2007)
  • other studies find that breastfeeding (and more so if it is prolonged) is a protective factor for osteoporosis and postmenopausal hip fracture, (Crandall 2017, Cooke 2017, Jiménez 2015, Bjørnerem 2011, Sadat 2005)
  • and other authors find an association between prolonged breastfeeding and low BMD, with a higher prevalence of osteoporosis and fractures (not especially hip) after menopause. (Yoo 2021, Lee 2020 y 2019, Hwang 2016, Kim 2015, Tsvetov 2014, Bolzetta 2014, Okyay 2013)

The diagnosis of osteoporosis during pregnancy or breastfeeding does not contraindicate breastfeeding. An adequate intake of calcium and vitamin D is important during pregnancy and lactation, through a balanced diet and regular exercise and with the help of dietary supplements if necessary.

Most osteoporosis treatments are compatible with breastfeeding.

Only in the rare disease known as Pregnancy and Lactation-associated Osteoporosis (PLO) is suppression of breastfeeding indicated. (Lujano 2022, Jun 2020, Jia 2020, Cohen 2019)


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Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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José María Paricio, founder of e-lactancia.
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References

  1. Lujano-Negrete AY, Rodríguez-Ruiz MC, Skinner-Taylor CM, Perez-Barbosa L, Cardenas de la Garza JA, García-Hernández PA, Espinosa-Banuelos LG, Gutierrez-Leal LF, Jezzini-Martínez S, Galarza-Delgado DÁ. Bone metabolism and osteoporosis during pregnancy and lactation. Arch Osteoporos. 2022 Feb 19;17(1):36. Abstract
  2. Capozzi A, Scambia G, Lello S. Bone metabolism in pregnancy and lactation. Minerva Obstet Gynecol. 2021 Dec;73(6):697-703. Abstract
  3. Yoo JE, Shin DW, Han K, Kim D, Yoon JW, Lee DY. Association of Female Reproductive Factors With Incidence of Fracture Among Postmenopausal Women in Korea. JAMA Netw Open. 2021 Jan 4;4(1):e2030405. Abstract Full text (link to original source)
  4. de Bakker CMJ, Burt LA, Gabel L, Hanley DA, Boyd SK. Associations Between Breastfeeding History and Early Postmenopausal Bone Loss. Calcif Tissue Int. 2020 Mar;106(3):264-273. Abstract
  5. Jun Jie Z, Ai G, Baojun W, Liang Z. Intertrochanteric fracture in pregnancy- and lactation-associated osteoporosis. J Int Med Res. 2020 Feb;48(2):300060519858013. Abstract Full text (link to original source)
  6. Jia P, Wang R, Yuan J, Chen H, Bao L, Feng F, Tang H. A case of pregnancy and lactation-associated osteoporosis and a review of the literature. Arch Osteoporos. 2020 Jun 25;15(1):94. Abstract
  7. Grizzo FMF, Alarcão ACJ, Dell' Agnolo CM, Pedroso RB, Santos TS, Vissoci JRN, Pinheiro MM, Carvalho MDB, Pelloso SM. How does women's bone health recover after lactation? A systematic review and meta-analysis. Osteoporos Int. 2020 Mar;31(3):413-427. Abstract
  8. Lee EN, Choe SY, Choi EH, Lee MJ. Effects of Parity and Breast Feeding Duration on the Risk of Osteoporosis in Postmenopausal Korean Women: A Systematic Review and Meta-Analysis. J Menopausal Med. 2019 Aug;25(2):100-107. Abstract Full text (link to original source)
  9. Lee EN. Effects of Parity and Breastfeeding Duration on Bone Density in Postmenopausal Women. Asian Nurs Res (Korean Soc Nurs Sci). 2019 May;13(2):161-167. Abstract Full text (link to original source)
  10. Yan G, Huang Y, Cao H, Wu J, Jiang N, Cao X. Association of breastfeeding and postmenopausal osteoporosis in Chinese women: a community-based retrospective study. BMC Womens Health. 2019 Aug 13;19(1):110. Abstract Full text (link to original source)
  11. Cohen A, Kamanda-Kosseh M, Dempster DW, Zhou H, Müller R, Goff E, Colon I, Bucovsky M, Stubby J, Nickolas TL, Stein EM, Recker RR, Lappe JM, Shane E. Women With Pregnancy and Lactation-Associated Osteoporosis (PLO) Have Low Bone Remodeling Rates at the Tissue Level. J Bone Miner Res. 2019 Sep;34(9):1552-1561. Abstract Full text (link to original source)
  12. Abou-Dakn M. [Health effects of breastfeeding on the mother]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018 Aug;61(8):986-989. Abstract
  13. Cooke-Hubley S, Kirby BJ, Valcour JE, Mugford G, Adachi JD, Kovacs CS. Spine bone mineral density increases after 6 months of exclusive lactation, even in women who keep breastfeeding. Arch Osteoporos. 2017 Aug 16;12(1):73. Abstract
  14. Crandall CJ, Liu J, Cauley J, Newcomb PA, Manson JE, Vitolins MZ, Jacobson LT, Rykman KK, Stefanick ML. Associations of Parity, Breastfeeding, and Fractures in the Women's Health Observational Study. Obstet Gynecol. 2017 Jul;130(1):171-180. Abstract Full text (link to original source)
  15. Hwang IR, Choi YK, Lee WK, Kim JG, Lee IK, Kim SW, Park KG. Association between prolonged breastfeeding and bone mineral density and osteoporosis in postmenopausal women: KNHANES 2010-2011. Osteoporos Int. 2016 Jan;27(1):257-65. Abstract
  16. Jiménez-Arreola J, Aguilera Barreiro Mde L. Lactancia materna como factor preventivo para la osteoporosis en mujeres adultas. [Breast feeding as preventive factor for osteoporosis in adult women] Nutr Hosp. 2015 Dec 1;32(6):2600-5. Abstract Full text (link to original source)
  17. Mori T, Ishii S, Greendale GA, Cauley JA, Ruppert K, Crandall CJ, Karlamangla AS. Parity, lactation, bone strength, and 16-year fracture risk in adult women: findings from the Study of Women's Health Across the Nation (SWAN). Bone. 2015 Apr;73:160-6. Abstract Full text (link to original source)
  18. Chowdhury R, Sinha B, Sankar MJ, Taneja S, Bhandari N, Rollins N, Bahl R, Martines J. Breastfeeding and maternal health outcomes: a systematic review and meta-analysis. Acta Paediatr. 2015 Dec;104(467):96-113. Abstract Full text (link to original source)
  19. Kim HJ, Kwon H, Oh SW, Lee CM, Joh HK, Kim Y, Um YJ, Ahn SH. Breast Feeding Is Associated with Postmenopausal Bone Loss: Findings from the Korea National Health and Nutrition Examination Survey. Korean J Fam Med. 2015 Sep;36(5):216-20. Abstract Full text (link to original source)
  20. Bolzetta F, Veronese N, De Rui M, Berton L, Carraro S, Pizzato S, Girotti G, De Ronch I, Manzato E, Coin A, Sergi G. Duration of breastfeeding as a risk factor for vertebral fractures. Bone. 2014 Nov;68:41-5. Abstract
  21. Lebel E, Mishukov Y, Babchenko L, Samueloff A, Zimran A, Elstein D. Bone mineral density in gravida: effect of pregnancies and breast-feeding in women of differing ages and parity. J Osteoporos. 2014;2014:897182. Abstract Full text (link to original source)
  22. Kovacs CS. Osteoporosis presenting in pregnancy, puerperium, and lactation. Curr Opin Endocrinol Diabetes Obes. 2014 Dec;21(6):468-75. Abstract
  23. Tsvetov G, Levy S, Benbassat C, Shraga-Slutzky I, Hirsch D. Influence of number of deliveries and total breast-feeding time on bone mineral density in premenopausal and young postmenopausal women. Maturitas. 2014 Mar;77(3):249-54. Abstract
  24. Okyay DO, Okyay E, Dogan E, Kurtulmus S, Acet F, Taner CE. Prolonged breast-feeding is an independent risk factor for postmenopausal osteoporosis. Maturitas. 2013 Mar;74(3):270-5. Abstract
  25. Yumusakhuylu Y, Turgut ST, Icagasioglu A, Baklacioglu HS, Atlig RS, Murat S, Suer N. Bone mineral changes during pregnancy and lactation. Gynecol Endocrinol. 2013 Aug;29(8):763-6. Abstract
  26. Bjørnerem A, Ahmed LA, Jørgensen L, Størmer J, Joakimsen RM. Breastfeeding protects against hip fracture in postmenopausal women: the Tromsø study. J Bone Miner Res. 2011 Dec;26(12):2843-50. Abstract Full text (link to original source)
  27. Lenora J, Lekamwasam S, Karlsson MK. Effects of multiparity and prolonged breast-feeding on maternal bone mineral density: a community-based cross-sectional study. BMC Womens Health. 2009 Jul 1;9:19. Abstract Full text (link to original source)
  28. Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, Trikalinos T, Lau J. Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep). 2007 Apr;(153):1-186. Review. Abstract Full text (link to original source)
  29. Sadat-Ali M, Al-Habdan I, Al-Mulhim AA, El-Hassan AY. Effect of parity on bone mineral density among postmenopausal Saudi Arabian women. Saudi Med J. 2005 Oct;26(10):1588-90. Abstract
  30. Sowers M, Corton G, Shapiro B, Jannausch ML, Crutchfield M, Smith ML, Randolph JF, Hollis B. Changes in bone density with lactation. JAMA. 1993 Jun 23-30;269(24):3130-5. Abstract

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