Randomized, placebo-controlled, calcium supplementation study in pregnant Gambian women: effects on breast-milk calcium concentrations and infant birth weight, growth, and bone mineral accretion in the first year of life.
What this study found
Calcium supplementation during the second half of pregnancy did not improve breast-milk calcium, infant birth weight, growth, or bone mineral status. Breast-milk calcium concentrations were similar between groups at L02, L13, and L52, and there was no significant effect on calcium, phosphorus, or the calcium-to-phosphorus ratio at any timepoint or on change over time. Infant birth weight was also similar (3.01 Ȁ 0.37 kg in the supplemented group vs 2.98 Ȁ 0.36 kg in placebo), and DXA outcomes at 13 and 52 weeks were generally similar between groups. There was a signal of slower increase in…
- Study & population
- Randomized, double-blind, placebo-controlled trial in pregnant women in rural The Gambia with uncomplicated singleton pregnancies and very low habitual calcium intake.
- Intervention
- Pregnant women received 1500 mg/day elemental calcium as calcium carbonate, given as 3 chewable tablets containing 500 mg elemental calcium each.
- Key limitation
- The trial was conducted in a single rural Gambian population with very low baseline calcium intake, which may limit generalizability.
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Open PDFOriginal abstract
BACKGROUND Growth and bone mineral accretion in Gambian infants are poorer than those in Western populations. The calcium intake of Gambian women is low, typically 300-400 mg Ca/d, and they have low breast-milk calcium concentrations, which result in low calcium intakes for their breastfed infants. A low maternal calcium supply in pregnancy may limit fetal mineral accretion and breast-milk calcium concentrations and thereby affect infant growth and bone mineral accretion. OBJECTIVE We investigated the effects of calcium supplementation in Gambian women during pregnancy on breast-milk calcium concentrations and infant birth weight, growth, and bone mineral accretion. DESIGN A randomized, double-blind, placebo-controlled supplementation study was conducted in 125 Gambian women who received 1500 mg Ca/d (as calcium carbonate) or placebo from 20 wk of gestation until delivery. Infant birth weight and gestational age were recorded. Breast milk was collected, and infant anthropometric and bone measurements were performed at 2, 13, and 52 wk after delivery. Infant bone mineral status was assessed by using single-photon absorptiometry of the radius and whole-body dual-energy X-ray absorptiometry. RESULTS Compliance with the supplement was high. No significant differences were detected between the groups in breast-milk calcium concentration, infant birth weight, or growth or bone mineral status during the first year of life. A slower rate of increase in infant whole-body bone mineral content and bone area was found in the supplement group than in the placebo group (group x time interaction: P = 0.03 and 0.02, respectively). CONCLUSION Calcium supplementation of pregnant Gambian women had no significant benefit for breast-milk calcium concentrations or infant birth weight, growth, or bone mineral status in the first year of life.