Following on from the data on the menopause and breastfeeding, I know many women are advised to limit the duration of breastfeeding in order to protect their own bone density. This sadly often shows a mis understanding of breastfeeding and its importance to the ongoing health of mother and child.
I hope this information taken from Breastfeeding and Chronic Medical Conditions helps
Osteoporosis and breastfeeding fact sheet
” I have severe early onset osteoporosis causing 12 spinal compression fractures. The challenges were
managing my pain relief, deciding on a medication that could treat my low bone density whilst
breastfeeding…. but also positioning and attachment with a spine that is inflexible and incredibly
painful. Just lifting my new-born caused some fracturing. We nailed the pain relief and medication
for osteoporosis side of things and with help positioning side of things. I was an experienced breast
feeder but had never fed whilst so immobile and in pain before. Thankfully I am still feeding him now,
over 4 years later. I am not cured; I never will be as it is a degenerative disease. I continue to suffer
fractures. But looking back the help I had to enable me to breastfeed was the only way I was able to
independently care for my new baby. I was bed bound and could never have managed formula
preparation. Now that I too am in the shield group, I am thankful that I am still breastfeeding to help
boost his immune system in this most terrifying time.“
Description
Osteoporosis is a condition that weakens bones, making them fragile and more likely to fracture. It
develops slowly over several years and is often only diagnosed when a fall or sudden impact causes a
bone to break. Osteoporosis affects over 3 million people in the UK. It is frequently diagnosed in
women after the menopause but not exclusively.
Other risk factors for osteoporosis:
- taking high-dose steroid tablets for more than 3 months
- other medical conditions – such as inflammatory conditions, hormone-related conditions, or
malabsorption problems - a family history of osteoporosis – particularly a hip fracture in a parent
- long-term use of certain medicines that can affect bone strength or hormone levels, such as
anti-oestrogen tablets that many women take after breast cancer having or having had an eating disorder such as anorexia or bulimia - having a low body mass index (BMI)
- not exercising regularly
- heavy drinking and smoking
It can be prevented by taking regular, weight bearing exercise, eating a diet rich in calcium and
vitamin D (or taking supplements), abstaining from smoking and high alcohol use.
Treatment - Calcium and vitamin D supplements: minimum 10 micrograms vit d and 700mg -1200mg
calcium - Bisphosphonates: bisphosphonates should always be taken on an empty stomach with a full
glass of water, standing or sitting upright for 30 minutes after taking them. Other drinks or
foods should be avoided for 30 minutes and 2 hours.
Alendronic acid (Alendronate ™) https://www.ncbi.nlm.nih.gov/books/NBK501621/
Ibandronic acid (Bonviva ™) https://www.ncbi.nlm.nih.gov/books/NBK501616/
Risedronic acid (Actonel™) – no information on levels in breastmilk but poor oral
bioavailability
Zoledronic acid – no information on levels in breastmilk but poor oral bioavailability
Raloxifene – no information and may suppress lactation - Denosumab: an alternative for women with osteoporosis who have been through the
menopause if a bisphosphonate is not suitable or is not tolerated. It is given twice a year by
injection and helps to slow down bone loss. As with bisphosphonates, there is a small risk of
a rare problem of the jawbone, called osteonecrosis - Breastfeeding and Bone Density Research
The effects of breastfeeding on mothers’ bone health (UNICEF Baby Friendly Hospital Initiative
https://www.unicef.org.uk/babyfriendly/news-and-research/baby-friendly-research/maternalhealth-research/maternal-health-research-bone-density/ - Caroline J. Chantry et al (2004). Lactation Among Adolescent Mothers and Subsequent Bone
Mineral Density. Arch Pediatr Adolesc Med. 158:650-656 - Paton LM et al (2003). Pregnancy and lactation have no long-term deleterious effect on
measures of bone mineral in healthy women: a twin study. Am J Clin Nut 77: 707-14 - Kalkwarf HJ, Specker BL (1995) Bone mineral loss during lactation and recovery after
weaning. Obstet Gynecol 86: 26-32
Kalkwarf HJ (1999) Hormonal and dietary regulation of changes in bone density during
lactation and after weaning in women. J Mammary Gland Biol Neoplasia 4: 319-29
Further information on Osteoporosis
Royal Osteoporosis Society https://theros.org.uk
please email me wendy@breastfeeding-and-medication.co.uk if you need more information
