Evidence map›Paper›PMID 38111005›Full record

SynthesisInternational breastfeeding journal2023

Lumbar spine bone mineral density in women breastfeeding for a period of 4 to 6 months: systematic review and meta-analysis.

Larissa Brazolotto Ferreira, Keny Gonçalves Tirapeli, Carla Cristiane Silva, Tamara Beres Lederer Goldberg

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in International breastfeeding journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 6 citations in OpenAlex.

  1. Pregnancy vitamin D supplementation and bone mineral density of the mother: a post hoc analysis of the MAVIDOS randomised placebo-controlled trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Trial
  2. Article
  3. Recovery of BMD after pregnancy and breastfeeding-a 10-yr prospective observational study of 25-yr-old women.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025
    Observational
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Larissa Brazolotto Ferreira *Postgraduate Program in Tocogynecology, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
Keny Gonçalves Tirapeli *Postgraduate Program in Tocogynecology, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
Carla Cristiane SilvaDepartment of Human Movement Studies, Londrina State University (UEL), Londrina, Brazil.
Tamara Beres Lederer GoldbergPostgraduate Program in Tocogynecology, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil. tamara.goldberg@unesp.br.
Universidade Estadual Paulista (Unesp) · BRUniversidade Estadual de Londrina · BR

Funding

FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo), and Pro-Rector and the Vice Presidency for Research - UNESP FAPESP - Grants (07/07731-0, 2011/05991-0 and 2015/04040-2)
6 · The paper itself

Abstract

backgroundDuring the breastfeeding period, important transient changes in calcium homeostasis are verified in the maternal skeleton, to meet the demand for calcium for breastmilk production. The literature is inconclusive regarding the causes and percentages of involvement of bone densitometry resulting from exclusive breastfeeding (4 to 6 months).

methodsThis article aims to systematically review the literature, to determine the occurrence, intensity, and factors involved in alterations in maternal bone mineral density (BMD), during a period of 4 to 6 months of exclusive breastfeeding. The search descriptors "woman", "breastfeeding", "human milk", and "bone mineral density" were used in the electronic databases of the Virtual Health Library, Scielo (Scientific Electronic Library Online), CAPES Periodicals Portal, LILACS, Embase, PubMed/Medline, Cochrane, Scopus, and Web of Science in June 2023. Inclusion criteria for breastfeedingmothers were; aged to 40 years, primigravida, exclusively breastfeeding, with BMD assessments using dual-energy X-ray absorptiometry (DXA), with values expressed at baseline and from 4 to 6 months postpartum. The Jadad scale, Newcastle-Ottawa Scale, and Oxford Centre for Evidence-based Medicine - levels of evidence were adopted to assess the quality of the studies. For the meta-analytical study, statistical calculations were performed.

resultsInitially, 381 articles were found using the search strategy and 26 were read in full. After risk of bias analysis, 16 articles remained in the systematic review and four were included in the meta-analysis. The studies showed a reduction in bone mass in the lumbar spine in the first months postpartum (4 - 6 months), when compared with a longer period of breastfeeding (12-18 months). The breastfeeding group presented a greater impact in the meta-analysis than the control group (non-breastfeeding, pregnant, or immediate postpartum), with a reduction in BMD in the lumbar spine of -0.18 g/cm

conclusionsOur results demonstrated a transitory reduction in bone densitometry of the lumbar spine during exclusive breastfeeding for 4 to 6 months, which was gradually restored later in the postpartum period. More prospective studies are needed to better understand the topic.

trial registrationPROSPERO platform (nº CRD42021279199), November 12th, 2021.

Indexed as

Bone DensityBreast FeedingAgedCalciumFemaleHumansLumbar VertebraePostpartum PeriodPregnancyCalciumBone mineral densityBreastfeedingLactation

Identifiers

PMID38111005
PMCPMC10729562
OpenAlexW4389920272

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.