title: Severe hypercalcemia in a lactating woman in association with moderate calcium carbonate supplementation: a case report.
abstract: BACKGROUND
  Lactation results in dramatic bone resorption and decreased urinary calcium excretion due to rapidly falling estrogen levels and probably increased levels of parathyroid hormone-related protein.
  
  
  METHODS
  A healthy, 36-year-old woman developed severe hypercalcemia several days after beginning breast-feeding her second child. During and after this pregnancy, she supplemented a high calcium diet with moderate amounts of calcium carbonate in an attempt to avoid an osteoporotic fracture that occurred while she was breast-feeding her first child.
  
  
  CONCLUSIONS
  Because the metabolic changes that occur during lactation predispose a woman to hypercalcemia, the daily recommended daily allowances for calcium should not be exceeded during breast-feeding.
authors.affiliation: Section of Endocrinology, Department of Internal Medicine, Gundersen Lutheran Medical Center, La Crosse, Wisconsin, USA. rhcaplan@gundluth.org
authors.forename: Robert H
authors.initials: RH
authors.lastname: Caplan
authors.forename: Christine D
authors.initials: CD
authors.lastname: Miller
authors.forename: Paul D
authors.initials: PD
authors.lastname: Silva
mesh_terms: D000328:Adult; D002136:Calcium, Dietary / Q000008:administration & dosage* / Q000009:adverse effects; D003937:Diagnosis, Differential; D019587:Dietary Supplements / Q000009:adverse effects; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology; D007774:Lactation; D011644:Puerperal Disorders / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology; D012720:Severity of Illness Index
chemical_list: D002136:Calcium, Dietary