I am interested to know if anyone has any data or anecdotes about women who
are osteopenic and still nursing as they approach menopause, and what effect
menopause has on the ability to regain bone mass postweaning. I am also
interested to know if anyone has any anecdotes on the effect of continuous
repeated tandem nursing and hence uninterrupted nursing for years on bone
mass and whether that affects the potential for osteoporosis.

I have been asked about a mother, now 43 and experiencing some perimenopausal
symptoms, who is nursing her 4th child, now 3, and who has been essentially
nursing and/or pregnant for most of the past 10 or 12 years. She also is
somewhat overweight, gets little exercise, and has a history of having smoked
10-20 pack years prior to her childbearing years. Scans of femoral and lumbar
density indicate a bone loss of 1.61 and 2.14 standard deviations from
premenopausal standards, respectively.

I just spoke with Heidi Kalkwarf in Cincinnati, one of the authors of the
1995 article "Bone Mineral Loss During Lactation and Recovery After Weaning,"
from Obstetrics & Gynecology, and she tells me there is no data, and she has
applied for an NIH grant to study just this issue. Even the mechanism of
postweaning bone growth is unknown, although it is thought to be the
re-exposure to estrogen and even progestins.

So, without access to any data, I still have questions: Your experience, your
speculation, your understanding of the mechanisms involved would be welcome.

Is this woman's osteopenia related to her unbroken decade of nursing, without
opportunity for rebound, or more related to her past history of smoking,
etc.? And, should she be told to wean now, before she gets further into
menopause? Should she be put on estrogen replacement therapy? (I have
actually recommended both of the latter, even though in general I am very
reluctant to recommend either.)

I know there are many moms out there who have tandem nursed consecutive kids
and I'm sure there are those who have done so into their later years.
Certainly a hundred years ago there were many wetnurses who nursed many
children continuously for many years, and well into menopause: would we
know--would there be a folk history of frequent broken bones in those women?


While I am sending this question out on Lactnet, I admit that I my reading is
intermittent and inconsistent.

So, please send any anecdotal information (or data?) to me directly by
e-mail: [log in to unmask]

Thanks so much.  Tina Smillie