Breastfeeding as the sole source of milk for 6 months and adolescent bone mineral density

Osteoporos Int. 2017 Oct;28(10):2823-2830. doi: 10.1007/s00198-017-4106-0. Epub 2017 Jun 6.


Little is known regarding the relationship between early life factors and bone mineral density (BMD). We found a positive association between breastfeeding for at least 6 months, without formula supplementation, and whole body adolescent BMD z-score.

Introduction: The aim of the study is to assess the role of breastfeeding BF on adolescent bone mineral density (BMD) in a cohort prospectively followed since infancy.

Methods: We studied 679 participants from an infancy iron deficiency anemia preventive trial in Santiago, Chile, followed to adolescence. Breast and bottle feeding were ascertained weekly from 4 to 12 months. At 16 years, whole body BMD was assessed by DEXA. Using linear regression, we evaluated associations between BF duration and BF as the sole source of milk and adolescent BMD z-score, adjusting for possible infancy, adolescent, and background confounders.

Results: Mean birth weight and length were 3.5 (0.3) kg and 50.7 (1.6) cm. For at least 6 months, BF was the sole source of milk for 26.3% and with supplementation for 36.7%. For 37%, BF was provided for less than 6 months. Mean 16-year BMD z-score was 0.25 (1.0). Covariates included male sex, birth length, and gestational age. BF as the sole source of milk ≥6 months, compared to BF < 6 months, was associated with higher adolescent BMD z-score adjusting for covariates (β = 0.29, p < 0.05). Mixed BF was not significantly related to adolescent BMD z-score (β = 0.06, p = 0.47). For every 30 days of BF as the sole source of milk, adolescent BMD z-score increased by 0.03 (p = 0.01).

Conclusion: BF without formula supplementation for at least 6 months was associated with higher adolescent BMD z-score and a suggestive trend in the same direction for BMD suggests that exclusivity and duration of BF may play a role in adolescent bone health.

Keywords: Bone health; Developmental origins of disease; Lactation; Osteoporosis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Absorptiometry, Photon
  • Adolescent
  • Age Factors
  • Aging / physiology
  • Birth Weight / physiology
  • Body Height / physiology
  • Bone Density / physiology*
  • Breast Feeding*
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena / physiology
  • Infant, Newborn
  • Male
  • Prospective Studies
  • Time Factors