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Effects of Calcium Supplementation on Calcium Homeostasis and Bone Turnover in Lactating Women¹

Division of General and Community Pediatrics (H.J.K), Children’s Hospital Medical Center Cincinnati, Ohio 45229; E. A. Martin Program in Human Nutrition (B.L.S.), South Dakota State University, Brookings, South Dakota 57007; and Institute for Health Policy and Health Services Research (M.H.), University of Cincinnati Medical Center, Cincinnati, Ohio 45267

Address all correspondence and requests for reprints to: Heidi J. Kalkwarf, Ph.D., Division of General and Community Pediatrics, Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio 45229. E-mail: heidi.kalkwarf{at}chmcc.org

Lactation is a time of calcium flux, because women secrete approximately 210 mg calcium/day in breast milk, and they experience a transient bone loss. The objectives of this study were to determine the effect of calcium supplementation on adaptive responses in calcium homeostasis during lactation and after weaning. Two cohorts of women participated in a 6-month randomized calcium supplementation trial. Lactation cohort women (97 lactating, 99 nonlactating) were studied during the first 6 months post partum, and weaning cohort women (95 lactating, 92 nonlactating) were studied during the second 6 months post partum. Lactating women in the weaning cohort weaned approximately 1.5 months after enrollment. PTH was 18–30% lower in lactating than in nonlactating women (P < 0.01). Serum 1,25-dihydroxyvitamin D was 11–16% higher in lactating than in nonlactating women and remained elevated for approximately 1.5 months after weaning (P = 0.06). Calcium supplementation decreased serum PTH and 1,25-dihydroxyvitamin D in lactating and nonlactating women similarly. At 6 months, the calciuric response to calcium supplementation was less in lactating (compared with nonlactating) women (P = 0.06). Biomarkers of bone turnover were higher in lactating than in nonlactating women during lactation and after weaning but were not effected by calcium supplementation. Calcium supplementation has little effect on lactation-induced changes in the calcium economy.

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