Cher Sealy posted recently about a woman who was diagnosed with pregnancy-associated osteoporosis. I've checked a few references and have some things to share. Hope these don't duplicate what Cher has already found.
1. In Lawrence (1999), page 220
"The risk of osteoporosis in later life is greatest for women who have never borne infants, somewhat less for those who have borne infants, and measurably less for those who have borne and breastfed infants (2 refs given). The bone mineral loss experienced during pregnancy and lactation is temporary. Bone mineral density returns to normal following pregnancy and even following extended lactation when mineral density may exceed the original baseline (1 ref given)."
2. There is a two-part article on osteoporosis, recently published in the journal "American Family Physician"
(March 1, 2001, volume 63, #5, pp 897-904 and March 15, 2001, volume 63, #6, pp 1121-1128) in which the problem is thoroughly discussed (one part is evaluation and assessment; the other is on nonpharmacologic and pharmacologic treatment). I couldn't find specific mention of "pregnancy-associated osteoporosis". The risk factors listed for osteoporosis are: female gender, petite body frame, white or Asian ancestry, sedentary lifestyle, nulliparity, increasing age, high caffeine intake, renal disease, lifelong low calcium intake, smoking, excessive alcohol use, long-term use of certain drugs, postmenopausal status, low body weight, impaired calcium absorption.
Perhaps there are some additional factors for this mom?? Without knowing the specifics, it's always difficult to be sure you have the whole picture. If mom was a candidate for Fosamax, Hale indicates that the drug has very poor oral bioavailability, particularly when ingested with milk (!), so oral absorption for the baby would be unlikely.
Perhaps more information about medications and other treatment options that might be used would help her in making decisions.
Jeanne M. Brotherton, RNC, IBCLC
Bellingham, WA
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