Calcium and vitamin D metabolism during lactation

Calcium transfer to the fetus in late pregnancy and the subsequent transfer of calcium to milk represent the greatest challenges to calcium homeostasis in adult animals. The adaptation of the maternal calcium homeostatic mechanisms is the result of a complex interplay between calciotropic hormones and the tissues, intestine, bone, and kidney, responsible for providing the large amounts of calcium needed to support fetal skeletal growth and lactation. In this review, we will discuss general calcium homeostasis followed by a review of the specific adaptations required by the human, rat, and cow to meet fetal and lactational demands for calcium. Finally, we will review what is known about the regulation of calcium transfer from the plasma to the milk.