Pregnancy And Breastfeeding Gave Me Osteoporosis At 38

by Andrea Cottrell, M.D.
Originally Published: 
A mother breastfeeding her child
JGI/Tom Grill/Getty

I expected some changes when I first became pregnant, but never imagined that my bones would begin to fail me well before the onset of menopause. I was healthy and was following my doctor’s advice, so chronic illness wasn’t something I considered. I was wrong. Over the next 6 years, I had two more babies and I suffered 8 bone fractures.

Becoming a mother is one of the most life-changing events a woman will experience. The immediate and overwhelming happiness I felt when I first held my newborn daughter was indescribable. In an instant, she became the center of our world, and during those early months, she taught me the beauty of selflessness and unconditional love.

But, as the days ran into nights in a blur of continuous sleep deprivation, my health began to decline. Every time I bumped into the edge of a chair during a middle-of-the-night feeding, or my foot grazed the edge of the couch when I was hurrying out the door, I ended up with a fractured toe. Then, I slipped at home and broke my right arm at the elbow. When minimal trauma causes a broken bone, it is known as a fragility fracture, a term most women don’t hear until well past child-bearing age.

My husband worked many nights and weekends during this time, and not unlike many other moms caring for small children, I was exhausted. I was nursing all night, every night. I was trying to do everything right. I read that I should be breastfeeding and should not be sleep training. I was supposed to be enjoying every moment although I suffered from constant pain everywhere, including back pain that kept me from doing any exercise. I could hardly carry my toddler. I was told by several doctors it was a muscle strain, although I had never heard of a muscle strain causing pain for years at a time.

I was often so tired from the pain, the broken bones, and caring for my three kids that I sometimes skipped meals in hopes of taking a short nap. Even putting food in the microwave and eating it felt like extra work. I nursed through several episodes of painful mastitis requiring antibiotics. I felt so grateful to have these amazing children, and at the same time, each day felt like a monumental struggle. I should have stopped nursing to make life easier, but I didn’t. I trudged through with a sling on my arm or my foot wrapped in medical tape. Nothing was more important than the health of my babies, so when I was told that breast is best, how could I feed them formula without the guilt?

After finally weaning my youngest baby, I needed a little taste of freedom. I started walking, first around the block, and eventually, I walked for several miles at a time. As I progressed to jogging, the knee pain started. At first, I only felt it during the first few minutes of my run. It would disappear, only to recur the next time I ran. Since the pain always went away, I didn’t worry too much. Then the pain started waking me at night, and eventually, I was unable to run at all. After a week of limping around, I ended up in the emergency room unable to walk. I was diagnosed with stress fractures in both legs. I spent the next three weeks in a wheelchair. This was a wake-up call that something was very wrong. I was 38.

During months of recovery and learning to walk again with crutches, I saw a total of five different doctors trying to get a diagnosis. Luckily, I stumbled across a Columbia University study investigating a disease I had never heard of: pregnancy and lactation-associated osteoporosis (PLO). It turned out I was not alone after all. In fact, there were women like me around the world, many of whom had suffered more severe injuries after pregnancy or while breastfeeding, such as vertebral fractures.

Anyone who has struggled to receive a diagnosis knows the feeling of helplessness, and I will forever be grateful to this medical team for finally listening to me, diagnosing and treating me, and giving me hope for the future. I am now a part of their study, and I hope that the work being done will help other women of all ages who are struggling with osteoporosis.

There may be environmental and genetic factors that contribute to this rare form of osteoporosis, some of which are still being studied and worked out. Regardless, it would have been great to feel less judgment from others about my feeding choices, since breast isn’t always best. Breastfeeding doesn’t always come easy, and it can take a lot out of an already tired mom. Like many new mothers in our society, I had no safety net, no village, and no help. At times I ate a crappy diet, my sleep was constantly interrupted, and I was unable to exercise. I had three pregnancies within four years, including a month of bed rest. In addition, I breastfed each of my children for 1-2 years. I wish I realized that switching to infant formula earlier and allowing my husband to help with feedings would have given me and my bones a much-needed break.

Mothers who have recently given birth, especially breastfeeding mothers, who have unexplained pain or experience one or more fragility fractures should discuss the need for osteoporosis screening with their physician. If a doctor doesn’t take these concerns seriously, it is time for a new doctor. This is especially important in the context of a family history of osteoporosis, prolonged inactivity (such as bed rest), the use of certain medications, or decreased exposure to natural sunlight. A simple bone density scan and a vitamin D level could have saved me a lot of pain and suffering after my first fragility fracture.

Chronic disease affects the entire family, but sometimes a little adversity can make us truly grateful for what really matters in life. After losing the ability to walk normally for months, I appreciate so many little things that I once took for granted. Also, I know that my kids will be okay with a little TV or screen time, junk food, or boredom. My kids are surrounded by love, they are safe, they are happy, and they are full of empathy for others. I am just glad I am now healthy enough to enjoy this journey with them.

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