Ferreira Larissa Brazolotto, Tirapeli Keny Gonçalves, Silva Carla Cristiane, Corrente José Eduardo, Goldberg Tamara Beres Lederer
PhD of the Postgraduate Program in Tocogynecology, Botucatu Faculty of Medicine, Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil.
Adjunct Professor of the Department of Human Movement Studies, Universidade Estadual de Londrina (UEL), Londrina, São Paulo, Brazil.
PLoS One. 2025 Aug 4;20(8):e0328254. doi: 10.1371/journal.pone.0328254. eCollection 2025.
The aim of this study was to evaluate the evolution of bone mass in exclusive breastfeeding mothers (EBF) for 6 months, and another cohort, who had also exclusively breastfed their children while concomitantly donating breast milk for 6 months (EBF+), with evaluation of their bone mass during the subsequent 6-month period of complementary breastfeeding.
A group of exclusive breastfeeding mothers (n = 38) were evaluated at 15 days and six months postpartum, and a second group of EBF-donors (EBF+) (n = 39) were evaluated at six months and one year postpartum. Bone mineral content (BMC) and density (BMD) were evaluated by bone densitometry (DXA) and bone turnover markers were determined: osteocalcin (OC), bone alkaline phosphatase (BAP), and carboxy-terminal telopeptide (S-CTX).
There was a significant decrease in BMD in the lumbar spine (1.107 ± 0.109 and 1.075 ± 0.112 g/cm2; p < 0.001), total body (1.135 ± 0.086 and 1.119 ± 0.085 g/cm2; p < 0.001), and total proximal femur over the six months of EBF compared to the values obtained from the same EBF group at 15 days postpartum (mean percentage decreases in BMD of -3.4 ± 3.7% (p < 0.001) in lumbar spine, -2.5 ± 3.4% (p < 0.001) in total proximal femur, and -1.7 ± 1.9% (p = 0.001) in total body). For the group of EBF + who practiced complementary breastfeeding after 6 months, densitometric results indicated a tendency to incorporation of bone mass, with a mean percentage increase in BMD of 5.0 ± 3.9% for lumbar spine, and 1.6 ± 3.4% for total proximal femur.
There was a significant physiological mobilization of bone mineral density in the lumbar spine, total body, and total proximal femur after six months of EBF. In the EBF+ group, even with continued complementary breastfeeding, densitometric results were higher than those observed at 6 months, indicating a continuous increase over time.
本研究旨在评估纯母乳喂养6个月的母亲（EBF）以及另一组在纯母乳喂养孩子的同时还捐赠母乳6个月的母亲（EBF+）的骨量变化，并在随后6个月的混合母乳喂养期间评估她们的骨量。
一组纯母乳喂养母亲（n = 38）在产后15天和6个月时接受评估，另一组EBF捐赠者（EBF+）（n = 39）在产后6个月和1年时接受评估。通过骨密度测定法（DXA）评估骨矿物质含量（BMC）和密度（BMD），并测定骨转换标志物：骨钙素（OC）、骨碱性磷酸酶（BAP）和羧基末端肽（S-CTX）。
与同一EBF组在产后15天时获得的值相比，在纯母乳喂养的6个月期间，腰椎（1.107±0.109和1.075±0.112 g/cm²；p < 0.001）、全身（1.135±0.086和1.119±0.085 g/cm²；p < 0.001）和股骨近端总体的BMD显著下降（腰椎BMD平均下降百分比为-3.4±3.7%（p < 0.001），股骨近端总体为-2.5±3.4%（p < 0.001），全身为-1.7±1.9%（p = 0.001））。对于在6个月后进行混合母乳喂养的EBF+组，密度测定结果表明有骨量增加的趋势，腰椎BMD平均增加百分比为5.0±3.9%，股骨近端总体为1.6±3.4%。
纯母乳喂养6个月后，腰椎、全身和股骨近端总体的骨矿物质密度出现显著的生理性动员。在EBF+组中，即使继续进行混合母乳喂养，密度测定结果也高于6个月时观察到的值，表明随着时间的推移持续增加。
