Impact of lactational performance on calcium metabolism through bone mass density in marginally nourished Bangladeshi women
Objective: See the impact of breast-feeding behaviour/or pattern on bone mass density (BMD) in a group of Bangladeshi women. Methodology: Four hundred Bangladeshi women aged 20-81 years were studied for their nutritional status, child birth events,, breast-feeding behaviour, and effect of calcium metabolism ascertained by studying their BMD of distal end of radius and ulna during 1995-1996 in an urban postgraduate hospital in Dhaka. History of breast-feeding was ascertained, and reproductive performance records were taken. A bone densitometer —single-photon x-ray absorptiometry (SEXA) —was used for measuring the BMD. Results: The mean age ofJhe subjects was 41.9+14.6 years, and the mean parity was 4.5±2.9. The mean BMD of radius and ulna (g/cm ) was 0.42±0.07. The results of the study showed that the BMD was negatively correlated with age of the subjects (r=0.87, p<0.001) and parity (r=0.71, rxO.OOl). The peak BMD was observed during the age of 25-39 years which declined after the age of 40 years. The BMD was negatively associated with the duration of total months of exclusive breast-feeding reported by the women (r=0.42, rxO.00001), the number of infants bora (r<0.38, rxO.00001), the total number of months with lactational amenorrhoea (r=0.25, p<0.01), and the total months of partial breast-feeding of the infants born (r=44, p<0.0001). The mean BMD also reduced significantly with the increase in parity (<p,0.001), controlling for age, workload, body mass index, parity, and other lactational amenorrhoea (slope 6.8, p<0.04). Conclusion: The results of the study suggest that the BMD of Bangladeshi women is negatively related with their prolonged breast-feeding pattern. The suggestion on policy implies that women's dietary adequacy in terms of the essential minerals is an important public health issue, and deserves attention to strengthen campaign for the protection and promotion of breast-feeding to improve child nutrition and survival.