Maternal Obesity, 25-Hydroxy Vitamin D Concentration, and Bone Density in Breastfeeding Dyads.
J Pediatr. 2017 Aug;187:147-152.e1. doi: 10.1016/j.jpeds.2017.04.024. Epub 2017 May 23.
Sen S1, Penfield-Cyr A2, Hollis BW3, Wagner CL 3.
1 Dept of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA. ssen2 at bwh.harvard.edu.
2 Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA.
3 Division of Neonatology, Department of Pediatrics, Medical U of South Carolina, Charleston, SC.
- Vitamin D required for breastfed infants – daily or monthly, infant or mother – Jan 2017
- Breastfeeding mother getting 6400 IU of Vitamin D is similar to infant getting 400 IU – RCT Sept 2015
Probably at least 2X more would be needed if obese
- Monthly vitamin D dosing is better than daily dosing for children and elderly (more likely to be taken) – June 2017
- Breast Feeding increased risk of low bone density by 24 percent – Sept 2015
Note: 24% increased risk without having an obese mother
Healthy pregnancies need lots of vitamin D has the following summary
|1. Miscarriage||2.5 times||Observe|
|2. Pre-eclampsia||3.6 times||RCT*|
|3. Gestational Diabetes||3 times||RCT*|
|4. Good 2nd trimester sleep quality||3.5 times||Observe|
|5. Premature birth||2 times||RCT*|
|6. C-section - unplanned||1.6 times||Observe|
|7. Depression AFTER pregnancy||1.4 times||RCT*|
|8. Small for Gestational Age||1.6 times||meta-analysis|
|9. Infant height, weight, head size |
within normal limits
|10. Childhood Wheezing||1.3 times||RCT*|
|11. Additional child is Autistic||4 times||Intervention|
|12.Young adult Multiple Sclerosis||1.9 times||Observe|
|13. Preeclampsia in young adult||3.5 times||RCT*|
|14. Good motor skills @ age 3||1.4 times||Observe|
|15. Childhood Mite allergy||5 times||RCT*|
|16. Childhood Respiratory Tract visits||2.5 times||RCT*|
To examine the association between maternal body mass index (BMI) and serum 25-hydroxy vitamin D [25(OH)D] concentration and bone density in mother-infant pairs.
The study was a secondary analysis of 234 exclusively breastfeeding dyads who were recruited in the first postpartum month for a randomized controlled trial of maternal vs infant vitamin D supplementation. Mean 25(OH)D concentrations and bone mineral density (BMD) were compared by BMI group. The adjusted association between maternal BMI and 25(OH)D and bone density was examined at 1, 4, and 7 months postpartum.
Obese breastfeeding women had lower 25(OH)D concentrations and higher BMD than lean women at all 3 time points (P < .01). Higher maternal BMI was associated with lower maternal serum levels of 25(OH)D at 1, 4, and 7 months postpartum (adjusted β = -0.45 ng/ml per kg/m2, 95% CI -.076, -0.14, at 1 month) and higher BMD at the same time points (β = 0.006 BMD z score; 95% CI 0.003, 0.01 at 1 month). Seventy-six percent of infants were vitamin D deficient at 1 month of age. Infants born to overweight and obese mothers had lower 25(OH)D concentrations than infants of lean mothers (P < .01). For infants in the maternal supplementation group, higher maternal BMI was associated with lower 25(OH)D concentrations at 4 months (β = -0.68; 95% CI -1.17, -0.20) and lower bone density at 7 months (β = -0.001; 95% CI -0.002, -0.0001).
CONCLUSIONS: In exclusively breastfeeding dyads, maternal obesity is associated with lower maternal and infant serum 25(OH)D concentrations, which may impact infant bone density.
TRIAL REGISTRATION: ClinicalTrials.gov: NCT00412074.
PMID: 28549637 DOI: 10.1016/j.jpeds.2017.04.024