Hi Christina,So this just keeps coming up over and over. I have a lot in my
files on this, including personal histories and studies. In the end, it is
all very similar. Bone density decreases during lactation, and then rebounds
after weaning, often to levels better than they would have been if the woman
had never breastfed at all.  There are other factors at work, including
hormone levels, calcium intake, exercise, etc, - all of the usual factors
involved in bone metabolism. Although there may be hormonal factors beyond
her control, such as lower estrogen levels while breastfeeding, she can make
sure that she is getting plenty of calcium, vitamin D and magnesium, all of
which are involved in bone formation. The doctors might also want to test
other hormones, such as PTH, that influence bone metabolism. If they indeed
believe that it is multifactorial, what others factors are they
investigating and possibly treating?  Are they concerned that she may be at
more risk for osteoporesis later in life if she does not continue
breastfeeding - many studies do show a protective effect for breastfeeding
once a woman has stopped having babies and lactating.

I guess if it were me, I would continue nursing and concentrate on those
things that I could control - diet, including supplements if necessary, and
exercise - that I know are supportive of bone growth. I would look into all
the hormones that might influence my bone metabolism and have blood tests
run to see if they might be out of wack and perhaps treatable (except for
estrogen - adding that would likely result in a significant drop in milk
supply.)  Is this women currently dealing with bone fractures? If so, that
is a more serious situation.

I don't know what she wants you to tell her. The amount of bone loss during
lactation differs for each individual. There are things she can do to keep
bone loss to a minimum, but there are no guarantees when it comes to
numbers, as far as I know.  As with so many issues, it is very individual.
Weaning now will bring up her bone density at this time, but at what
long-term cost to both her and her child?  A difficult decision to make
unless she is willing to really look at the research and push her doctors to
consider other options besides weaning.

Sharon Knorr, BSMT(ASCP), IBCLC
Newark, NY   USA

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