I know many of you have gone through this and have posted on my other discussions, but I am really lost here. I have osteoporosis of pregnancy that started when I was 27 weeks. It has been 18 days since I delivered and my endo has advised me to stop breastfeeding because my bone density scores are so low...-2.7 in both of my hips and -3.85 in my spine. I do have pain in my spine and had another test to see if there were any fractures, but am waiting for results. Anyway, baby is only days and now i am forced to wean. I haven't started the process yet, so sad to do so, but i am also afraid of a spinal fracture that could take years to heal. What should I do? I know I need to think about my body so I can take care of my baby, but it is hard. How are spinal scores before fractures occur? Should I try to breastfeed another month and do another density test to see if things get worse? Or should I be happy with the time I have had and start weaning asap? AAAh, so much to think about!
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Breastfeeding...should I stop???
- By mcgee334
- Posted October 18, 2009 at 4:06 pm · 19 replies
- In Premenopausal women (ages 25-50) with osteoporosis
- Shared with the public
Explore topics in this discussion:
Cancer Counseling Fractures Pregnancy Cervical cancer Breast cancer Ovarian cancer Pain Osteoporosis Estrogens Acupuncture Stress
19 replies
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- By SuzaFrancina
- Posted October 19, 2009 at 6:25 am
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There is a wealth of information available on nutrition and osteoporosis that not all doctors are aware of. My philosophy is that it is always important to educate yourself and do your own research. Breastfeeding has been shown to actually protect against osteoporosis.
Here are some interesting things to consider:
A lactating woman does not produce estrogen in high levels. Because of the estrogen suppressing effects of breastfeeding, she cannot readily absorb calcium. Calcium is, however, always leaving her body in the milk she makes for her child.
During lactation a mother may experience decreases of bone mineral. A nursing mom's bone mineral density may be reduced in the whole body by one to two percent while she is still nursing. This is gained back, and bone mineral density may actually increase, when the baby is weaned from the breast. This is not dependant on additional calcium supplementation in the mother's diet. Breastfeeding has been shown to actually protect against osteoporosis
Though it has been commonly believed that breastfeeding mothers need approximately 400 to 800 mg. more calcium in their daily diet, this theory had not been backed up by science. A study published in the August 1997 issue of the New England Journal of Medicine (NEJM) has found that breastfeeding mothers do not need extra calcium to help guard against bone loss (N Engl J Med 1997;337:523-8).
In an editorial in the same issue of the NEJM, Dr. Anne Prentice of the Medical Research Council states, "A picture is beginning to emerge showing that human lactation is associated with alterations in calcium metabolism, including the temporary mobilization and subsequent restitution of bone mineral, that are independent of dietary calcium intake and unresponsive to increases in calcium intake."
The Institute of Medicine's recommendations (August, 1997) also concur with the results of this study. They recommend that nursing mothers over the age of 18 consume 1,000 mg. of calcium daily -- the same as other adults.
These findings can help to assure the nursing mother that breastfeeding does not negatively impact bone mineral density, and seems in fact to decrease her chance of developing osteoporosis.
Source: http://parenting.ivillage.com/baby/bbreastfeed/0,,3x74,00.html#ixzz0UH5XTDK 3
- By SuzaFrancina
- Posted October 19, 2009 at 6:30 am
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Note, I posted this information on osteoporosis and breastfeeding under another discussion but seems important to also post it here, in case other mothers have similar concerns. There is quite a bit of new information available in this area. Here is another interesting article:
Breastfeeding Reduces the Chance of Osteoporosis
"Yes, breastfeeding your baby today might keep you from a hip fracture when you're 70! Think of it as your child helping you out in your old age. Following is a review of an Australian study on osteoporosis and breastfeeding. Following that are references to medical studies on the topic.
Osteoporosis and the protective effects of past breastfeeding experience as reported in 'The Compleat Mother', Spring 1996"
"This condition of reduced bone mass predisposes to fractures, particularly of the upper thigh and spine, even under little stress. Dietary factors that can affect the risk of osteoporosis are calcium, vitamin D, salt, alcohol, animal protein and caffeine. It is postulated that adequate calcium intake during growth and until the mid-twenties, when peak bone mass is achieved, reduces risk of osteoporosis, and an an adequate intake in later life allows for the increased rate of bone loss and less effective assimilation from the diet; the role of dietary calcium in the treatment of osteoporosis is still uncertain."
"Bone density decreases in life in both sexes, but post-menopausal women are at the greatest risk of developing osteoporosis, because estrogens protect against bone loss. A 1990-91 study of Sydney women aged 65 years and over suggested that breastfeeding protected against hip fracture in old age, with a dose-response relationship between average duration of breastfeeding per child and risk of hip fracture. It is estimated that 20-25 per cent of women, by the age of 70 years, will have undergone hospitalization for bone fractures resulting from osteoporosis, and that 16 per cent of those with hip fractures will die within six months."
- By SuzaFrancina
- Posted October 19, 2009 at 6:34 am
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References for above article:
Royal Australian College of Physicians Working Party on osteoporosis.
"Osteoporosis: its causes, prevention and treatment."
Mod Med Aust 1991; Aug:3 7-41 .
"Breastfeeding Reduces the Chance of Osteoporosis"
Cumming RG, Klineberg RI.
"Breastfeeding and other reproductive factors and the risk of hip fractures in elderly women."
Inr J Epidemiol 1993;22 684-691.
Blaauw, R. et al.
"Risk factors for development of osteoporosis in a South African population."
SAMJ 1994; 84:328-32.
- By SuzaFrancina
- Posted October 19, 2009 at 6:36 am
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A few more things to consider:
What's good for baby is also good for mother.
Summary: Women who breastfeed reduce their chances of pre-menopausal breast cancer, cervical cancer and osteoporosis.
Reduces the risk of breast cancer:
Women who breastfeed reduce their risk of developing breast cancer by as much as 25 percent. The reduction in cancer risk comes in proportion to the cumulative lifetime duration of breastfeeding. That is, the more months or years a mother breastfeeds, the lower her risk of breast cancer.
Reduces the risk of uterine and ovarian cancer:
One of the reasons for the cancer-fighting effects of breastfeeding is that estrogen levels are lower during lactation. It is thought that the less estrogen available to stimulate the lining of the uterus and perhaps breast tissue also, the less the risk of these tissues becoming cancerous.
Lessens osteoporosis:
Non-breastfeeding women have a four times greater chance of developing osteoporosis than breastfeeding women and are more likely to suffer from hip fractures in the post-menopausal years.
Sources:
http://www.askdrsears.com/html/2/T020700.asp
http://www.breastfeeding.org/articles/reasons.html
- By bethanyb
- Posted October 19, 2009 at 5:35 pm
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I am also a huge breastfeeding advocate, but from what I have read on here, I am inclined to encourage you to wean your baby. I nursed my first child for 2 years. I found out I had osteoporosis when my second child was 10 months old. I waited until he was 1 to wean him and even then it made me really sad to do it. I still wonder if it was the right thing to do.
My lowest t-score was -2.6 in my spine after breastfeeding for most of the last 3 years, so you are starting out with a much lower baseline.
There are several moms on here who fractured bones while breastfeeding. The natural decline in bone density while breastfeeding may not be a problem for people who start with a normal bone density, but if your bones are already weak, your density could get dangerously low.
You have probably read this post by Waters:
http://www.inspire.com/groups/national-osteoporosis-foundation/discussion/o steoporosis-and-breastfeeding/
Do you mind me asking what symptoms you had that lead to your diagnosis? I'm not familiar with osteoporosis of pregnancy and it sounds like you haven't had any fractures. Do you know that your bone density was better before pregnancy?
One theory I have about breastfeeding that I haven't seen written anywhere is that it makes your body acidic, which is bad for bones. I have read that breastmilk is alkaline and producing something alkaline would make the mother's body more acidic. For whatever time you continue breastfeeding, I think it could be helpful to eat a highly alkaline diet (lots of vegetables and water).
I can imagine how difficult this decision must be for you to make especially just after having a baby. I hope you don't mind if I pray for you and I hope you are able to enjoy your new baby whatever you decide about breastfeeding!
- By YoungMum88
- Posted October 19, 2009 at 8:03 pm
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There's a few things i want to say here. I am a huge believer in breastfeeding, when its possible, YESs there a huge benefits for the baby and for the mother such as preventing cancer and osteoporosis later on in life, i totally agree with this. But i also believe this is only the case when you dont have osteoporosis right now!
I also think that the following quote from SuzaFrancina is not entirely true for our situation "What's good for baby is also good for mother."
Whats good for your baby is having a mother that can look after it like a mother should and sacrificing your health to breastfeed is just not worth it as i have discovered.
I believe that unless you have been or are in this situation you cannot understand the risks and consequences. YES there is lots of information out there supporting breastfeeding. In fact there is information supporting anything and everything but that doesnt mean its true. But i dont think anything beats first hand information. And as you will read other stories on here they all have had a similiar experience, 2 - 3 months after their baby is born is when your bone density reaches a low enough point and fractures happen.
Anyway this is my opinion and i have been in the same position as you and if there is one thing i want to get out of my experience its to warn other mums of the pain and heartache that can happen. So whatever you decide just be careful xx
- By Lee29
- Posted October 20, 2009 at 10:39 am
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I wanted to share my personal experience with osteoporosis and breastfeeding. I was diagnosed 3 months after my daughter was born although had symptoms at 36 weeks of pregnancy (which were misdiagnosed at the time). I have something called transient regional osteoporosis (TRO) of the hips and spine which is a condition of pregnancy/post partum. I was also told by my endocrinologist to immediately stop breastfeeding as it takes too much calcium out of your body, creating a high risk for fractures. I started supplementing immediately (1600 calcium, 2000 vitamin D) although was told oral supplements will not replace what calcium breastfeeding is taking out of your body. By the way, in pregnancy your hips are most affected but post partum, if you are breastfeeding, the spine is most impacted. I had not fractured but my bone density scores were terrible. Against medical advice, I continued breastfeeding (my personal choice with obvious risks involved) and started doing everything possible to prevent fracture and take care of my bones. I reduced how frequently I was breastfeeding and began to supplement (that was my compromise). It is true that breastfeeding is very dangerous when you have low bone density scores and you are at high risk for fracture. Many women on this site with lactation induced osteoporosis did fracture and experienced considerable pain and difficulty caring for their babies. It is also true that breastfeeding has protective value for your bones but that occurs later in life not when you need it now.
So my advice to you would be to carefully examine your situation and make the decision that is best for you and your family. It's a hard decision and you must carefully examine the risks (fracture) which would obviously impact caring for your baby. I was stubborn and fortunately, I did not fracture. I plan to stop breastfeeding soon (weaning gradually - my daughter is almost 9 months) and then hopefully my bone density scores will gradually improve (unless I had undiagnosed osteoporosis prior to pregnancy which is not known. I have a positive family history for osteoporosis). By the way, I was in considerable pain due to TRO which improved at the 6 month mark (consistent with the diagnosis). I have also never had problems with my bones and was very healthy prior to this diagnosis.
I don't know if this helps or not but I wish you the best in making this decision. Whatever you decide, please know that both breastfeeding and bottle/formula feeding are both fine options for your infant. Sending lots of positive thoughts your way.
- By tam512
- Posted October 20, 2009 at 11:07 am
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Based on my experience with osteoporosis and breastfeeding, and from what I have read from women on this board and others, I would recommend weaning as well. Breastfeeding will absolutely lower your bone density more (although it may recover post-weaning), and with a bone density that's already low, you are increasing your risk for fracture. With that said, this decision is a personal one, and you need to be comfortable with what you decide.
I have had two pregnancies, i made it through both of them with no major back problems, and about 3 months into breastfeeding I fractured. The first time around, it wasn't so bad, I healed quickly (which was why i never was diagnosed), but with my second child, I had several fractures, and am still dealing with the pain over 2 years later. If I had known then what I know now, I absolutely would not have breastfed my children. And I am very well aware of the benefits of breastfeeding, but i do believe in this case in particular... breast is NOT best. The lowest that my bone density reached was -2.9 in my spine.
Again, this is a personal decision, and you need to decide what you feel comfortable with.
good luck
tracey
- By Koo
- Posted October 27, 2009 at 4:19 am
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What a difficult and emotional time for you. I am sorry to hear of your situation. There are a lot of breastfeeding Nazi's out there who make women who cannot breastfeed feel very guilty. Your bone density in your spine is very low and when you breastfeed the spine is where you lose most of your density. This is because the spine is made of more trabecular bone than other parts of the skeleton. When breastfeeding one always loses bone density even though when you are finished it recovers at a greater rate and you can even have higher density than what you started with this is why it is said that breastfeeding can help protect against osteoporosis. You are at very high risk of fracture at the moment and I fear that anymore loss may give you fractures. You have already give your baby with a great start with colostrum which is the most important. "What is good for baby is not necessarily what is good for mum". You need to look after yourself in order to be there for your baby. Try to take emotions out of it and look at it objectively. You are protecting yourself and in doing so protecting your baby. There are lots of great formulae's out there. Please don't feel guilty but be strong and do what you have to do to look after yourself. There are many women here who have fractured while breastfeeding and had an aweful time. It is very likely that your osteoporosis is pregnancy based and transient. It may recover quite quickly though I guess you don't know what it was before you started. I have low bone density and gave up breastfeeding because of it. I did breastfeed for a while before I discovered the problem and it was hard to stop. Though when I did I discovered that there are some bonuses to the bottle. I wish I could give you a big hug. Ultimately it is your decision but whatever decision you make go forward and be positive about your decision (after you have had a good cry) and please please don't feel guilty and don't let anyone make you feel guilty.
Take Care
Koo
- By SuzaFrancina
- Posted October 28, 2009 at 10:08 am
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Hello Ladies, I have read all your Comments with great interest. Here is Part One of my reply.
I agree that mothers whose skeletal structures are already fragile are faced with a dilemma.
I may have missed something but it appears that in this discussion there were very few Comments about nutrition. I noted that Lee29 wrote," I started supplementing immediately (1600 calcium, 2000 vitamin D) although was told oral supplements will not replace what calcium breastfeeding is taking out of your body."
I think what is missing from this discussion is how this situation might have been prevented had you received proper nutritional counseling from your doctor before, during and after your pregnancy.
I will forward your original question and Comments to experts in the field of prenatal nutrition, breastfeeding and osteoporosis. If they reply, I will publish their Comments on this site.
Part Two to follow.
- By Lee29
- Posted October 29, 2009 at 9:36 am
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Hi SuzaFrancina,
Thanks for your interest in this topic. Unfortunately, I don't think proper nutrition could have prevented my situation. I actually have an extremely healthy diet in general and really made sure that I was getting all the recommended food groups before, during and after pregnancy. I was also taking a pre-natal for quite a while prior to pregnancy and other recommended supplements during pregnancy. I exercised fairly regularly too. What I regret not doing was additional supplements of calcium and Vitamin D (although my D levels always tested fine) during pregnancy as I've learned that a prenatal does not contain much. Of course, at the time, I did not know I had an issue with my bones. Also, the etiology of transient regional osteoporosis (TRO) is not entirely clear so doctors are not sure why I developed this condition other than the fact I may have had an "exuberant" response to pregnancy (or possibly undiagnosed osteoporosis prior to pregnancy although I never had problems with my bones in the past). Now the one thing I am not aware of is whether TRO is the same condition as what other women are posting on this site. The difference between TRO and regular osteoporosis (if you can call it that) is that TRO completely goes away and you improve within 6-18 months. It's a rare pregnancy/post partum condition which doctors don't know much about. Nonetheless, breastfeeding has its impact which makes things much worse.
Having said that, I've become very interested in this topic (hence my presence on this site). I certainly would love to hear what you find out from the experts in breastfeeding and osteoporosis. I have contacted several in North America in my research but they had not heard of TRO and cited what you posted in your original e-mail up top. So unfortunately, not much is known in this area. So I will be eager to find out what you discover.
- By tam512
- Posted October 29, 2009 at 10:32 am
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Suzafrancina-
Although I appreciate hearing different points of view on this subject matter, I do feel that you were a little bit out of line with your last posting...
"I think what is missing from this discussion is how this situation might have been prevented had you received proper nutritional counseling from your doctor before, during and after your pregnancy".
It sounds to me that you are saying that we (the women on this site who have had the unfortunate experience of fracturing our spines with a newborn baby in tow) could have prevented our situation by nutritional counseling?
I received the same nutritional counseling as every other pregnant women... i took my prenatal vits (starting before i was pregnant), and was very conscious of what i was putting into my body both during and after my pregnancy. The only thing that I could've beefed up on was the vitamin D, but my levels were in the normal range, and I had no idea that there was a problem with my bones at the time. And actually, the current recommendation for vitamin D during pregnancy is less than 500u (although that may change in the future). In fact the only thing that I think that could've prevented my fractures would have been NOT breastfeeding.
I am now trying for baby #3, and have received counseling from two different endocrinologists and my OBGYN, with all of them in agreement that if and when the time comes, breastfeeding is not recommended (although they would never tell me I CAN'T breastfeed, that is a personal decision).
Mcgee334 was asking for advice on whether or not to stop breastfeeding, not what she could've done to prevent her situation. I have read hundreds of post from women on this site who have discovered that they have osteoporosis, after a lifetime of eating healthy and exercising. Sometimes there is nothing you can do to prevent your bodies' responses to certain experiences.
- By mcgee334
- Posted October 29, 2009 at 11:57 am
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I agree, it was a little out of line. I am happy that you are so passionate about the topic, but your posts come off aggressive. I think you are forgetting that I created the discussion for help and support. I welcome your ideas and information, but I wish you were more sensitive to this situation. It has been a very difficult pregnancy for me. I was diagnosed with TRO at 27 weeks. It was in both hips and my knees. They did not know it was in my back until I delivered. The pain was so terrible; I was on bed rest for 11 weeks…until I delivered. I am now starting to get some relief and have been able to walk around the block – something I have not been able to do in months. My bone density score in my back is so low that I do not want to take the chance of being put on bed rest again. I want to be able to take care and enjoy my daughter. I cried a lot over giving up breastfeeding, but we are now in our second week of weaning and it is going well. She has had breast milk for 5 weeks now and I have one more week left. I have also pumped, so she will have another week’s supply. As you can tell, I am very sensitive about this topic because I already feel that I have let my daughter down. So, it is hard to hear someone talk about how I could have prevented this situation.
I ate very well during pregnancy. I exercised, took prenatal vitamins, prenatal yoga and I even received acupuncture for the first 5 months. I drank milk and tried to get calcium into my diet. I did not have any symptoms of osteo prior to my pregnancy; therefore there is no telling whether I had it before. I did have a kidney stone prior to pregnancy and another at 34 weeks. After the second, my endocrinologist told me to stop with the calcium supplements and take it easy with calcium with my diet for the rest of the pregnancy because my body was not absorbing the calcium and it was all coming out in my urine. She did not instruct me cut it out completely, but limit the amounts. I did not start taking Vit-D until after I delivered because my Vit-D scores were fine. As stated before in other posts, TRO is a tricky disease that doctors do not know much about. I do suggest that you do some research on it and I think it will help answer a lot of questions.
Giving up breastfeeding was a very painful decision. I loved the bond my daughter and I created through the first few weeks, but we are still creating that bond…even more now because I can walk and take care of her. I want to thank everyone for their support and I hope that I recover quickly so I can put this all behind me.
- By mcgee334
- Posted October 29, 2009 at 7:56 pm
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suza,
i dont think we need a part two. you are out of line once again and have no idea what you are talking about. there is no need to contact the la leche league because they are not doctors and could not help with tro. again, educate yourself on this disease.
- By tam512
- Posted October 29, 2009 at 8:21 pm
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SuzaFrancina-
It has been widely studied that breastfeeding places a MUCH larger demand on your bones than pregnancy. Anyone who has done their research is aware of this.
I agree with Mcgee334, please no part two until you have done your homework. I'm sure you are not intending it, but your comments are a little insulting (atleast to me).
- By YoungMum88
- Posted October 30, 2009 at 7:15 am
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And to me! Like i said unless you have experienced the pain and trauma that so many of us have experienced its not something you can really comment on. I have spent many days and nights crying as well, this has been one of the hardest things i have and will probably go through. To all you other mothers out there i admire your strength, courage and sheer determination to keep going. Everyday is a struggle but i know just one look, smile and cuddle from your baby helps take the pain away for a moment. Bless you all xx
- By bethanyb
- Posted October 30, 2009 at 4:47 pm
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mcgee334,
It sounds like you made a wise decision that will be best for you and for you daughter. I hope you are able to heal quickly!
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