Effect on Vitamin D status of Breastfeeding Infants after Vitamin D3 Supplementation during Breastfeeding Lactation: A double-blind randomized controlled trial
Annals of Clinical Endocrinology and Metabolism, 2017; 1: 006-014. Published: 04 August 2017
Sathit Niramitmahapanya1*, Surasak Kaoiean2, Varaporn Sangtawesin3, Anusorn Patpanaprapan1, Narisa K Bordeerat4 and Chaicharn Deerochanawong1
Levels are in nmols, not ng
Note: Breast milk level is higher than mother’s blood level
- breastfed 962 items as of Sept 2017
- Breastfeeding mother getting 6400 IU of Vitamin D is similar to infant getting 400 IU – RCT Sept 2015
- Vitamin D required for breastfed infants – daily or monthly, infant or mother – Jan 2017
- Mother got 100,000 IU of vitamin D monthly, breastfeeding infant got a little – RCT Aug 2016
- Breastfeeding mothers and Vitamin D: supplement only themselves usually, 4 out of 10 used monthly rather than daily – Jan 2017
- Newborn Vitamin D - single dose is better than daily – RCT Sept 2016
- Monthly 120,000 IU of Vitamin D during lactation worked well - May 2016
- Children getting 60,000 IU monthly got to vitamin D level of 33 ng – Sept 2015
- 800 IU vitamin D for infant and 2000 IU for mother is good, not great – RCT Dec 2013
Background: Vitamin D deficiency in pregnancy increases several risks of breastfed mothers. To prevent these adverse events, vitamin D supplementation during pregnancy and lactation is recommended, but suggested dose ranges vary.
Objective: To determine whether vitamin D3 1,800 IU/d supplementation in lactating mothers improves the vitamin D status of their breastfed infants.
Materials and Methods: A randomized, placebo-controlled trial with Thai pregnant women was conducted. Lactating mothers (n=72) and their breastfed infants with insufficient maternal 25 hydroxyvitamin D (25(OH)D) levels in the third trimester were randomly assigned to two groups, one of which received 1,800 IU/d vitamin D supplementation and the other a placebo. Maternal serum 25(OH)D during lactation, cord blood, and 6-week breastfed infant serum were measured using LC-MS/MS.
Results: Mean maternal age (±SD) was 27±5 years, and pre-gestational BMI was 22.29±5 kg/m2. Maternal serum 25(OH)D at baseline was 22.29±7.15 nmol/L. At 6 weeks, both maternal 25(OH)D and infant 25 (OH) D levels had increased significantly in the vitamin D supplement group of mothers and infants (68.30±15.40, 40.40±12.56 nmol/L) compared to those in placebo groups (55.15±13.57, 24.28±17.20 nmol/L) (p <0.001, p<0.001). The changes in infant 25(OH)D levels increased substantially in the vitamin D supplement group but decreased in placebo(17.49±16.27 ng/ml compared to -1.34±19.23 nmol/L in the placebo group, p<0.001). The change of maternal 25(OH)D were positively correlation to the change of 25(OH)D level in breastmilk mothers and infants by r=0.697, p<0.001 and r=0.379, p=0.003 respectively.
Conclusions: Vitamin D3 supplementation to breastfed mother during lactation can increase serum 25(OH) D level in Thai breastfed mother and infants. Further work is needed to determine the optimum duration of vitamin D supplementation to normalized breastfed infants with 25(OH)D level >75 nmol/L.