Pregnancy and Lactation

Taking care of your bones is important throughout life, including before, during, and after pregnancy and breastfeeding. There are many actions you can take to promote strong bones for you and your growing baby.

Actions to Promote Strong Bones for You and Your Baby:

Choose a healthy plate that includes plenty of fruits and vegetables, lean protein, whole grains, and a calcium rich food. For more information about health and nutrition for pregnant and breastfeeding women visit the USDA choosemyplate.gov website

  • Eat the right amount of foods to gain a healthy weight during pregnancy
  • Consume the recommended amount of calcium each day, preferably from the food that you eat.
  • Get the recommended amount of vitamin D each day
  • Be physically active
  • Avoid smoking and alcohol

What do I need to know about calcium intake during pregnancy or breastfeeding?

Throughout your pregnancy, it is important to get the recommended amount of calcium each day, preferably from the foods you eat. It is concerning that many women do not consume the recommended amount of calcium during pregnancy. When you are pregnant, your baby needs plenty of calcium to grow and to develop strong bones. The calcium needed for your growing baby is greatest during the last 3 months of your pregnancy.

Calcium is so important to your baby during pregnancy that your body will try to protect your own bones in several ways. To begin with, you will absorb calcium better from the foods you eat when you are pregnant, especially at the end of your pregnancy. In addition, your body produces more estrogen during pregnancy and this hormone will protect your bones. If you do lose some bone mass during your pregnancy, it is usually restored soon after your baby is born. If you bottle-feed your baby, your bone mass will usually be restored soon after your baby’s birth. If you breastfeed your baby, your bone mass will usually be restored several months after breastfeeding is stopped. If a mother of an infant gets pregnant again quickly, bone mass lost during the first pregnancy may not be completely restored.

How much calcium do I need during pregnancy or breastfeeding?

The amount of calcium that you need each day during pregnancy or breastfeeding depends upon your age. The National Academy of Sciences recommends that women aged 19 and older who are pregnant or breastfeeding consume 1,000 mg (milligrams) of calcium each day. For pregnant teens, the recommended intake is 1,300 mg a day.

What foods are good sources of calcium?

Good sources of calcium include:

  • low-fat or fat-free dairy products, such as milk, yogurt, and cheese
  • certain dark green leafy vegetables, such as bok choy, collard greens, dandelion greens, kale, mustard greens, and turnip greens
  • canned sardines and salmon eaten with the bones
  • almonds and soy nuts
  • calcium-fortified foods (with calcium added)- such as milk alternatives (almond, coconut, rice, or soy beverages), orange juice, cereals, and tofu

What is the best way to get calcium?

To get the calcium you need each day, it is best to include a calcium rich food at each meal or snack. If you are not able to do so, you may not be getting the recommended amount of calcium. It is important to speak to your healthcare provider about your calcium intake. If you cannot get all of the calcium you need from the foods you eat, your healthcare provider may recommend that you take a calcium supplement. A calcium supplement can help fill the gap of calcium missing in your diet and help you add up your calcium to meet the daily calcium recommendations. It may be harmful to consume too much calcium, especially from supplements. It is important to take calcium supplements only when and in the amount advised by your healthcare provider.

What should I know about vitamin D during pregnancy or breastfeeding?

The current recommended intake of vitamin D during pregnancy and lactation is 600 IU (international units) or 20 micrograms per day. Most prenatal vitamins contain Vitamin D so it is important to check the nutrition label to find out how much it contains. In addition, there is approximately 100 IU or 2.5 micrograms of vitamin D in each 8-ounce cup of vitamin D fortified beverages that you drink. Vitamin D fortified beverages include all cow’s milk, some orange juice and most almond, coconut, rice. and soy beverages.To make sure that your breastfed baby gets the recommended amount of vitamin D, it is important to speak to your baby’s healthcare provider about getting a prescription for vitamin D supplement given as drops.

How can I keep my bones strong while breastfeeding?

The American Academy of Pediatrics recommends breastfeeding as the best way to feed infants up to 6 months of age and supports continued breastfeeding for the first year and beyond as long as it is desired by both you and your baby.  If you decide to breastfeed, it is important to take actions to promote strong bones for both you and your baby. Bone healthy actions include eating a nutrient-rich diet including a calcium rich food at each meal or snack, getting the right amount of vitamin D each day, exercising regularly, not smoking, and avoiding alcohol.

You may lose bone mass during breastfeeding.  One reason for this may be that during breastfeeding you produce less estrogen, the hormone that protects bones. The good news is the bone that you lose during breastfeeding is usually recovered within 6 months after breastfeeding ends.

What is the role of physical activity during pregnancy or lactation?

It is important to talk to your healthcare provider about your plans before you begin or resume physical activity. Like muscles, bones respond to exercise by becoming stronger. Regular physical activity, especially weight-bearing exercise that forces you to work against gravity, helps build and maintain strong bones. Examples of weight-bearing exercise include walking, climbing stairs, and dancing. Being active during pregnancy can benefit your health in other ways, too.

According to the American College of Obstetricians and Gynecologists, physical activity can:

  • help reduce backaches, constipation, bloating, and swelling
  • help prevent or treat gestational diabetes
  • increase energy
  • improve mood
  • improve posture
  • promote muscle tone, strength, and endurance
  • help you sleep better
  • help you get back in shape after your baby is born

Is it true that smoking and drinking alcohol can be harmful during pregnancy or breastfeeding?

There is nothing healthy about smoking. If you decide to smoke, it is important to consider that it is harmful for your baby, harmful for your bones, and harmful for your heart and lungs. To obtain information about how you can quit smoking, call the Smoker’s Quitline at 1-866-697-8487 (1-866-NY-QUITS) or visit The New York State Smoker’s Quitsite.  It is important to talk to your healthcare provider if you are currently using tobacco products and to discuss the resources available to help you quit.

Alcohol is harmful for pregnant and breastfeeding women and their babies. So, for your and your baby’s overall health and for strong bones, be sure to follow the recommendations made by  your healthcare provider and avoid drinking alcohol during this important time.

Are there special considerations about bone health if I am a pregnant teenager?

If you become pregnant during your teenage years, unlike older women, you are still actively building your own bones. The peak years of bone building are between 9 and 18 years. Bone building continues until 25, which is when peak bone mass is reached. If you are a pregnant teenager, you should be especially careful to get the recommended amount of calcium, 1300 mg (milligrams) each day. The best way to get the calcium you and your baby need is by including a calcium-rich food at each meal or snack. By eating a nutrient-rich diet, getting the right amount of calcium and vitamin D each day, your unborn baby’s need to develop its bones will not compete with your body’s need for calcium to build your own bones. You can both build strong, healthy bones during pregnancy.

What is transient osteoporosis in pregnancy?

It is rare for a woman to develop osteoporosis during pregnancy. Osteoporosis is a bone-thinning disease that can result in weaker bones. In rare cases, women may develop osteoporosis during pregnancy. This condition is called transient osteoporosis because it is usually temporary and short-lived. In these rare cases, it is possible that the weaker bones may be more likely to break. When this rare condition does occur, women who develop transient osteoporosis during pregnancy usually recover bone loss after their pregnancy ends or after they stop breastfeeding.