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| |    Calcium Supplementation in Pregnancy by Marjorie Greenfield, M.D. and Elisa Ross, MD reviewed by Marjorie Greenfield, M.D. Fetuses are efficient at getting the nutrition they need, even if they have to take it from their mothers' own bodies. Therefore, for most babies, extra vitamins are a bonus but not a necessity. In contrast, most expectant mothers do benefit from extra iron and calcium, which can be started in the second or even third trimester as a baby's nutritional demands increase. Usually 1,500 mgs of calcium per day is recommended for pregnant women, the equivalent of five helpings of milk, cheese, yogurt, or ice cream--or seven Tums (yes, Tums). While prenatal vitamins have some calcium, no multivitamin has enough to satisfy the prenatal requirement-it would have to be the size of a robin's egg! Calcium intake becomes more important as the pregnancy progresses and the baby's need for the element increases. The consequences of not getting enough calcium A woman is most able to build bone strength from her teen years through her thirties. Peak bone mass is reached by age 35 or even earlier. From then on, the best she can do with diet and exercise is maintain her bones-they will not get stronger. Most women in the United States don't get enough calcium in their diets, even when they're not pregnant. This is part of the reason that older women have such a high incidence of hip fracture. In addition to the teen years, after menopause, and when you are breastfeeding, pregnancy is one of the times in your life when you really need to pay attention to calcium intake. Sources of calcium Each of these has about 300 mg of calcium, a fifth of what a woman usually needs each day:
Problems with calcium supplements Calcium supplements such as calcium carbonate (which is the ingredient in Tums and other calcium-based antacids) cause many people to become constipated. Pregnancy itself can be constipating enough without adding this insult. If you are struggling with this problem, try to get calcium from your food rather than supplements, or try some of the preventive measures for constipation in pregnancy. If you determine that you need to take supplements, one method is to take one 500 or 600 mg calcium pill early in the day, and then take another in the evening if you haven't gotten a lot of dietary calcium that day. This can increase your awareness of your diet and, with any luck, gets you enough calcium without taking more pills than your GI tract can handle.
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