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Caroline J. Chantry, MD; Peggy Auinger, MS; Robert S. Byrd, MD, MPH

Arch Pediatr Adolesc Med. 2004;158:650-656.

Objective  To investigate the association of breastfeeding during adolescence with bone mineral density (BMD) during young adulthood.

Methods  Secondary analysis of data from the National Health and Nutrition Examination Survey III, a nationally representative cross-sectional survey conducted from 1988 through 1994, was performed. The BMDs for 5 regions of the proximal femur as measured by dual energy x-ray absorptiometry were compared for 5 groups of women aged 20 to 25 years (n = 819); the groups included those who had been: (1) adolescent mothers and had breastfed (n = 94), (2) adolescent mothers and had not breastfed (n = 151), (3) mothers who first gave birth as adults and breastfed (n = 67), (4) mothers who first gave birth as adults and had not breastfed (n = 89), and (5) nulliparous (n = 418). SUDAAN software was used to account for the complex sampling design of the National Health and Nutrition Examination Survey. Adjusted mean differences in BMD were estimated using least-squares linear regression.

Results  During young adulthood, women who breastfed during adolescence had higher adjusted BMDs, which was statistically significant in 4 of the 5 regions, than those who had not breastfed (total proximal femur area difference, 0.049 gm/cm² [95% confidence interval, 0.002-0.095]) and BMDs equivalent to nulliparous women (total proximal femur area difference, 0.024 gm/cm² [95% confidence interval, –0.023 to 0.071]). Adjusting also for obstetric variables, women who breastfed during adolescence had higher BMDs in all 5 regions compared with their peers who had not breastfed (total proximal femur area difference, 0.053 gm/cm² [95% confidence interval, 0.029-0.077]).

Conclusions  In this nationally representative sample, breastfeeding by adolescent mothers was associated with greater BMD in the proximal femur during young adulthood. Lactation was not found to be detrimental and may be protective to the bone health of adolescent mothers.

From the Department of Pediatrics at the University of California Davis Medical Center, Sacramento (Drs Chantry and Byrd); and the American Academy of Pediatrics Center for Child Health Research and the Department of Pediatrics at the University of Rochester School of Medicine and Dentistry, Rochester, NY (Ms Auinger).

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