Clare Claughton forwarded a message from a colleague about a mother
awaiting a diagnosis which is expected to be either transient osteoporosis
or osteonecrosis.
Regarding transient osteoporosis, the American Academy of Orthopedic
Surgeons states on their website
(http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=294&topcategory
=Hip):
1. Transient osteoporosis, as its name suggests, is temporary.
2. Women in the late stages of pregnancy (after the sixth month) are at
risk. (MY NOTE: Breastfeeding is not included in the list of risk factors.)
3. There is no clear explanation for what causes it. (MY NOTE:
Breastfeeding is not suggested as a possible cause.)
4. It generally resolves by itself over 6 to 12 months. (MY NOTE:
Importantly, the AAOs does *not* state anything like "The condition
generally resolves itself over 6 to 12 months unless the mother is
breastfeeding.)
Regarding osteonecrosis, the AAOS also states
(http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=237&topcategory
=Hip):
1. Risk factors include: age 20-50 years; hip dislocation or fracture;
alcoholism; corticosteroid use; glandular problems and diseases including
rheumatoid arthritis, sickle cell disease, myeloproliferative disorders,
Gaucher's disease, chronic pancreatis, Crohn's disease, Caisson's disease
or systemic lupus erythematosus. (MY NOTE: Breastfeeding is NOT included in
the list of risk factors. HAVE THESE ISSUES BEEN RULED OUT? And if she has
any of these conditions, then she might want to know which of them have
increased risks of developing in her child if she does not
breastfeed--e.g., Crohn's disease.)
2. Its cause is unknown.
3. "If you have osteonecrosis of the hip, your blood vessels gradually cut
off nourishment to the top of the thighbone (femur) where it fits in the
hip socket." (MY NOTE: What would breastfeeding have to do with blood
vessels doing such a thing in the mother's hip?)
I have several questions:
1. What is the training, education and experience of the mother's
physicians regarding breastfeeding?
2. Given that the AAOS does not mention breastfeeding as a risk factor for
either of these conditions, can the obstetric consultant and bone professor
in Liverpool provide references for any research that supports their
recommendation for weaning and the statement that "> she really is
vulnerable to fractures while she's feeding"?>
3. Has this woman been evaluated for vitamin D and/or calcium deficiency?
If not, why not? If so, what were the results? If she is deficient, then
why isn't supplementation an option instead of weaning?
4. Are there any patterns of behavior or circumstance that "run in the
family" that reduce this mother's exposure to the sun or her intake of
calcium (e.g., darker skin, living in a northern latitude, wearing
enveloping clothing, eating a low calcium diet) that could offer another
explanation for an apparent familial predisposition to "low calcium levels
in her bones"? (Good Mojab, C. Sunlight deficiency and breastfeeding.
Breastfeeding Abstracts [in press].)
I sincerely hope this mother can get the information that she needs to make
a fully informed decision which does not unnecessarily increase her and her
child's risk of a multitude of diseases and illnesses because of premature
weaning.
Best wishes,
Cynthia
Cynthia Good Mojab, MS, IBCLC
Ammawell
Email: [log in to unmask]
Web site: http://home.attbi.com/~ammawell
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