title: 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.
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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Medical Research Council Keneba, Keneba, The Gambia.
authors.forename: Landing M A
authors.initials: LM
authors.lastname: Jarjou
authors.forename: Ann
authors.initials: A
authors.lastname: Prentice
authors.forename: Yankuba
authors.initials: Y
authors.lastname: Sawo
authors.forename: M Ann
authors.initials: MA
authors.lastname: Laskey
authors.forename: Janet
authors.initials: J
authors.lastname: Bennett
authors.forename: Gail R
authors.initials: GR
authors.lastname: Goldberg
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Cole
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D001724:Birth Weight; D015519:Bone Density / Q000187:drug effects*; D001846:Bone Development / Q000187:drug effects / Q000502:physiology; D001942:Breast Feeding; D002118:Calcium / Q000032:analysis / Q000172:deficiency* / Q000652:urine; D002136:Calcium, Dietary / Q000008:administration & dosage*; D002657:Child Development / Q000187:drug effects* / Q000502:physiology; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005714:Gambia; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008895:Milk, Human / Q000737:chemistry*; D010349:Patient Compliance; D010758:Phosphorus / Q000032:analysis / Q000652:urine; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D002136:Calcium, Dietary; D010758:Phosphorus; D002118:Calcium