Wednesday, November 5, 2008

Calcium

During pregnancy, women need various vitamins and minerals to grow the baby - both the process and the baby's actual body. If a woman does not obtain enough of these vitamins and minerals to support her own body as well as the pregnancy, her body will always provide for the baby first, and her own nutrition will suffer.

Women who do not get enough calcium through food or supplement are at risk for osteoporosis (a reduction in bone mass) because of this fundamental principle. A pregnant woman's body will use the calcium stores in her bones to build the baby's skeleton.

Most sources recommend at least 1200mg of calcium each day for pregnant and breastfeeding women.

Do you know how much calcium is in your prenatal vitamin? Here are a few common brands and how much calcium each contains:
Rite Aid Brand Prenatal: 200mg
Rainbow Light Prenatal: 200mg
GNC Prenatal: 500mg
One-a-Day Prenatal: 300mg
Stuart Prenatal: 200mg
Surprised?

Clearly it's important for pregnant women to avoid counting on a prenatal vitamin to meet all of their calcium needs during pregnancy and breastfeeding.

What does calcium do?
As many of us know, calcium builds bones, so it is important prenatally for the baby's bones. Most us also know that calcium is in milk products - it's in breastmilk too! So, nursing mothers need calcium after baby is born too.

Several studies suggest that optimal amounts of calcium decrease the risk of pregnancy-induced high blood pressure (PIH) and pre-eclampsia.

In the Sears' Family Nutrition Book, Dr. Sears writes that "calcium is one of the most vital minerals for optimal functioning of your entire body" 955).


What are good food sources for calcium?
Good sources for calcium include dairy products like milk, yogurt, and cheese; fortified products like soy milk, orange juice, and cereal; fish; soy products; and greens. Here are some specific numbers:
  • Milk, low-fat: 1 cup = 300mg
  • Cottage Cheese: 1 cup = 155mg
  • Yogurt, low-fat, plain: 1 cup = 400mg
  • Parmesan cheese: 1 ounce = 336mg
  • Cheddar cheese: 1 ounce = 200mg
  • Sardines: 3 ounce = 371mg
  • Orange juice, calcium-fortified: 1 cup = 300mg
  • Tofu: 3 ounces = 190mg
  • Salmon: 3 ounces = 180mg
  • Broccoli, chopped (raw): 1/2 cup = 47mg
  • Almonds: 1 ounce = 80mg
  • Cereal, calcium-fortified: 1/2 cup = 100-200mg
  • Spinach, cooked: 1/2 cup = 136mg
  • Orange: 1 medium = 50mg
  • Soybean nuts: 1/4 cup = 116
  • Honestly, calcium was never a problem for me, because I love dairy. If I had one serving of cheese during the day (approximately 150mg), plus two glasses of milk for dinner (which equals 4 cups of milk, for a total of 1200mg), that was my calcium. People who don't tolerate dairy well, though, or who simply don't like it, need to be more mindful about including non-dairy calcium-rich foods in their daily diets.

    O'Mara offers these suggestions for obtaining 1,000mg of calcium through food sources:
  • 1 cup of milk or fortified soy or rice milk and
  • 1 cup of yogurt or fortified soy or rice yogurt or 1 cup of cooked collard or turnip greens and
  • 3 ounces of sardines or 1 stalk of broccoli and 1 cup of cooked turnip greens (26).

  • How is calcium absorbed?
    In Nutrition for a Healthy Pregnancy, Elizabeth Somer explains that "the total cost of pregnancy for a woman who has had two babies and has breast-fed them both for three months is approximately 100,000 mg, the equivalent of more than 333 extra glasses of nonfat milk!" (77).

    Somer offers this explanation for how the body handles its need for calcium during pregnancy and breastfeeding:
    "During gestation, it helps compensate for higher calcium needs by increasing the average amount absorbed into your bones from food - from about 20 to 25 percent prior to pregnancy to as much as 50 percent during pregnancy. While nursing, your body compensates for the loss in breast milk by reducing calcium losses in the urine . . . Regardless of absorption, you need to make sure you get enough of this mineral prior to, during, and after pregnancy" (78).
    In Having a Baby, Naturally, Peggy O'Mara explains that calcium is aborbed better when taken with vitamin C and vitamin D (26).

    O'Mara adds that "new research on calcium is beginning to make some experts believe that getting the body to retain calcium stores is much more crucial in the prevention of osteoporosis than how much of it you consume. Consuming too much alcohol and caffeine and eating a high-protein diet seem to deplete the body of its calcium stores more quickly. Exercising helps the body to hold on to its calcium supply" (26). These habits - avoiding alcohol, limiting caffeine, and exercising regularly - have many health benefits for pregnant women and their babies beyond calcium retention, but that's certainly one more good reason to make them a priority.

    Finally, calcium is aborbed best when smaller amounts of calcium-rich foods are eaten through the day and with meals.


    Calcium supplements
    For women who do not get enough calcium through their diet, a calcium supplement can make up the difference. Here is a list of recommendations to keep in mind if you decide to take a calcium supplement:
    Avoid "natural source" calcium pills like bone meal or oyster shell because they might contain lead, a very toxic metal.

    Take the calcium supplement at a different time - not at the same time as a prenatal or iron supplement, because calcium interferes with iron absorption, and iron interferes with calcium absorption.

    Take calcium with vitamin C and vitamin D (400IU) to increase absorption.

    Know how much of the calcium in your supplement is elemental - that's the amount that's actually usable by your body.

    Taking calcium before bed may help you sleep.

    Below are the books I used to write this post:
    The Pregnancy Book, by William Sears, MD and Martha Sears, RN
    The Harvard Medical School Guide to Healthy Eating During Pregnancy, by W. Allan Walker, MD
    Nutrition for a Healthy Pregnancy, by Elizabeth Somer, MA, RD
    Having a Baby Naturally, by Peggy O'Mara

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine

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