Calcium In Pregnancy: Its Importance And Food Sources

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Why Is Calcium Important During Pregnancy?

It is essential to consume sufficient calcium in pregnancy for the healthy development of the fetus. You also need calcium for your bones since they undergo several changes in pregnancy and need to stay strong (1).

Your baby meets its calcium needs by absorbing it from your body, particularly towards the third trimester.

  • On an average, the fetus demands 30g of calcium by the end of gestation (2).
  • The fetus requires 50mg/day during the second trimester and 250mg/day during the third trimester.

In the fetus, calcium

  • is crucial for strong dental growth
  • aids in nervous system development
  • helps in the formation of muscles
  • develops a strong heart

In pregnant women, calcium

  • fortifies the breast milk
  • produces fewer body fats, thereby lowering the risk of obesity
  • helps in proper functioning of nerves (3)
  • maintains a normal heart beat
  • facilitates a normal blood clotting

In order to make sure your body is getting proper calcium support, you need to consume the right amounts during pregnancy.

How Much Calcium Does A Pregnant Woman Need?

As per the US recommended daily allowance (RDA) guidelines, the calcium intake requirements are:

  • 19 years and older, including pregnant women – 1,000mg (1g) a day
  • 14 to 18 years – 1300mg (1.3g) a day (2)

[ Read: Reasons For Slow Fetal Growth ]

What is the maximum dose you can take at a time?

Do not take more than 500mg calcium at a time because your body can absorb only that much amount (4). You may take the recommended dose of 1,000mg in small quantities throughout the day.

If you do not take adequate amount of calcium in pregnancy, it could have an adverse impact on your body.

What If You Do Not Take Sufficient Amount Of Calcium?

Here are a few problems you could face due to calcium deficiency in pregnancy:

  • Your baby will absorb its quota of calcium from your bones. This, in turn, decreases your bone density.
  • Absorption of calcium from your bones will put you at the risk of osteoporosis. Osteoporosis leads to bone thinning, which results in weak and brittle bones.
  • Hypertension during pregnancy and premature delivery.
  • An interruption in the process of blood clots and hormone secretion.
  • Hypocalcaemia in low birth weight and preterm babies (4).

The best way to maintain the required levels of calcium is to have foods rich in calcium. So, what kind of food will give you sufficient calcium supply? Keep reading to know more.

Calcium-rich Foods To Consume During Pregnancy

Aim at having three servings of dairy products and non-dairy calcium foods every day. Here is the list of calcium rich foods that you can take. Choose and pick for some variety.

FoodsIntake amountCalcium in milligrams
Plain low-fat yogurt1 cup415
Vanilla soft-serve frozen yogurt1/2 cup103
Cottage cheese (1% milk fat)1 cup138
Partly skimmed mozzarella cheese1.5 ounces275
Low-fat fruit yogurt8 ounces245 to 384
Calcium-fortified soy milk8 ounces80 to 500
Whole milk8 ounces291
Skimmed milk8 ounces302
Calcium-fortified orange juice6 ounces200 to 260
Canned pink salmon, with bones and liquid3 ounces181
Tofu, firm, made with calcium sulfate1/2 cup204
Raw kale1 cup55
Raw bok choy1 cup40
White bread1 slice73
Turnip greens1/2 cup99
Spinach1/2 cup120
Cereal, calcium-fortified types1 cup100 to 1000

Sources: 5

You must have noted from the above list that dairy products are a major source of the nutrient. Therefore, it could be a problem for you if you are not consuming dairy for some reason.

[ Read: Calcium Rich Foods During Pregnancy ]

What If You Are Lactose Intolerant?

Lactose is the sugar found in milk. In lactose intolerant people, their body cannot break and digest the sugar (6) due to the lack of an enzyme called lactase. Lactose intolerance could lead to bloating, gas, diarrhea, and cramps.

If you are lactose intolerant, then these tips would be of help to get the required dose of calcium:

  • Milk is better tolerated if consumed with food. Add small quantities of milk in various foods that you eat in a day – make a pudding, soak your bread in it, cook your oats with milk.
  • Consume calcium-rich non-dairy food products including broccoli, greens vegetables, sardines, and tofu.
  • Try food that has reduced lactose content such as Lactaid milk, which is fortified with calcium (7). Also, you can discuss with your dietitian on other food products that have low lactose content.
  • Add a drop or two of liquid lactase in the dairy products. But, consult your doctor before using it.

Sometimes, you develop an aversion to certain foods during pregnancy. If milk is one of them, then you will miss on the major source of calcium.

What If You Do Not Want To Drink Milk?

The very smell or taste of milk could turn you off. In such case, you can substitute milk with other choices after consulting your doctor.

Here are a few ways to include calcium in your diet:

  • Eat a whole-wheat sandwich with cheese.
  • Include yogurt and cottage cheese in your diet.
  • Relish on non-dairy products, including spinach, broccoli, green peas, and mercury-free seafood.
  • Have fruit smoothies and puddings.
  • Opt for soy milk, which is rich in calcium.
  • Consult your doctor and go for chewable calcium tablets.

The last point brings us to an important question.

[ Read: Best Milk During Pregnancy ]

Should You Take Calcium Supplements During Pregnancy?

Supplements are taken when calcium supply from other sources is inadequate to meet the demands of the body during pregnancy.

The World Health Organization (WHO) recommends calcium supplements from the 20th week to the end of pregnancy for the all pregnant women, especially those who have a high risk of gestational hypertension. However, you need to make sure that the total intake of calcium is not exceeding the daily recommended allowance.

Here are a few points you should know about the calcium supplements:

  • If you are taking calcium supplements as well as iron tablets, then keep a gap of one to two hours between them.
  • Calcium carbonate tablets offer a good dose of calcium but require extra gastric acid to dissolve. Therefore, take them with your meal (8).
  • Calcium citrate gets easily absorbed and hence can be taken in between the meals.

Supplements not only replenish calcium levels in your body but also reduce the risk of preeclampsia (9). However, before you decide to pop those pills, you need to know the other side of the story.

Potential Side Effects Of Calcium Tablets During Pregnancy

  • The supplements may make you feel bloated or constipated.
  • Calcium supplements that contain dolomite, bone meal, coral, or oyster shell may contain lead in a small amount, which can harm the fetus (10).
  • High levels of calcium can lead to kidney stones (11). They, in turn, prevent the body from absorbing essential nutrients like zinc and iron.
  • If you are pregnant, make sure not to take more than 2,500mg a day or 3,000mg if you are 18 or younger (12).

If you are in the US, buy calcium supplements labeled USP (US Pharmacopoeia). The label indicates that the supplement has been tested for its quality standards. In other countries, you can look for the word ‘Purified’ on the labels; it means they are free from lead and other contaminants.

Taking calcium isn’t easy, right? It could be quite complicated. Hence, we are simplifying it for you.

[ Read: Is It Safe Calcium Tablets During Pregnancy ]

Important Points To Remember

While planning a healthy and calcium rich diet during pregnancy, make sure to keep the following points in mind:

  • Limit your calcium intake to the recommended dose.
  • Excessive calcium intake can cause digestive problems like constipation. It can also inhibit the absorption of iron and zinc from food into the blood.
  • Calcium works best with vitamin D. An adequate intake of vitamin D helps absorb calcium. Sun is a good source of vitamin D so stay outdoors in the early morning for a few minutes every day.

American Dietetic Association spokesperson and registered dietitian Ruth Frechman says, “A woman’s body can sense the increased needs of the fetus and produce more vitamin D. This enables pregnant women and nursing moms to absorb more of the calcium that’s in their food.”

  • Try to avoid soft cheeses such as brie and blue cheese because they pose a risk of food borne illnesses in pregnant women.

Getting adequate calcium in pregnancy ensures that your bones are strong enough to handle physical changes in your body and healthy fetus development. While calcium supplements are necessary, especially after the 20th week of pregnancy, it is preferable to meet your body’s calcium requirements by eating calcium-enriched dairy and non-dairy foods. Several vegetables, such as kale, turnips, and spinach, are also rich in calcium. Prepare a pregnancy diet plan that includes foods high in calcium and other essential nutrients to meet all of your nutritional requirements.

References

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  1. Calcium and bone health, Help Guide.
    https://www.helpguide.org/articles/healthy-eating/calcium-and-bone-health.htm
  2. Julie Heringhausen and Kristen S. Montgomery; (2005); Continuing educational module – Maternal calcium intake and metabolism during pregnancy.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595236/
  3. Pregnancy: Nutrition.
    https://my.clevelandclinic.org/health/articles/12593-pregnancy-nutrition
  4. Calcium and vitamin D, BHOF.
    https://www.bonehealthandosteoporosis.org/patients/treatment/calciumvitamin-d/
  5. Calcium content of foods, UCSF Health.
    https://www.ucsfhealth.org/education/calcium-content-of-foods
  6. Lactose intolerance facts, National Dairy Council.
    https://www.nationaldairycouncil.org/content/2016/lactose-intolerance-facts
  7. Milk Alternatives, GI Society.
    https://badgut.org/information-centre/health-nutrition/milk-alternatives/
  8. Nutrition and Wellness Resources, Brigham and women’s hospital.
    https://www.brighamandwomens.org/patients-and-families/meals-and-nutrition/bwh-nutrition-and-wellness-hub/nutrition-and-wellness-resources
  9. Moshood O Omotayo et al.; (2016); Calcium supplementation to prevent preeclampsia: translating guidelines into practice in low-income countries.
  10. Calcium needs for people with arthritis, Arthritis Foundation.
    Arthritis Foundation.
  11. Calcium oxalate stones
    https://www.arthritis.org/diseases/more-about/calcium-needs-for-people-with-arthritis
  12. Calcium and Vitamin D: Dynamic duo for bone health.
    https://americanbonehealth.org/wp-content/uploads/2016/07/Calcium-and-Vitamin-D-2013.pdf

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