The Effect of High-Dose Vitamin D Supplementation on Serum Vitamin D Levels and Milk Calcium Concentration in Lactating Women and Their Infants

Breastfeed Med. Spring 2006;1(1):27-35. doi: 10.1089/bfm.2006.1.27.

Abstract

Objective: Improve vitamin D status in lactating women and their recipient infants, and measure breast milk calcium concentration [Ca] as a function of vitamin D regimen.

Design/methods: Fully breastfeeding mothers were randomized at 1 month postpartum to 2000 (n = 12) or 4000 (n = 13) IU/day vitamin D for 3 months to achieve optimal vitamin D status [serum 25(OH)D > or =32 ng/mL (80 nmol/L)]. Breast milk [Ca], maternal and infant serum 25(OH)D and serum Ca, and maternal urinary Ca/Cr ratio were measured monthly.

Results: Mothers were similar between groups for age, race, gestation, and birth weight. 25(OH)D increased from 1 to 4 months in both groups (mean +/- SD): +11.5 +/- 2.3 ng/mL for group 2000 (p = 0.002) and +14.4 +/- 3.0 ng/mL for group 4000 (p = 0.0008). The 4000 IU/day regimen was more effective in raising both maternal and infant serum levels and breast milk antirachitic activity than the 2000 IU/day regimen. Breast milk [Ca] fell with continued lactation through 4 months in the 2000 and 4000 IU groups. Decline in breast milk [Ca] was not associated with vitamin D dose (p = 0.73) or maternal 25(OH)D (p = 0.94). No mother or infant experienced vitamin D-related adverse events, and all laboratory parameters remained in the normal range.

Conclusion: High-dose vitamin D was effective in increasing 25(OH)D levels in fully breastfeeding mothers to optimal levels without evidence of toxicity. Breast milk [Ca] and its decline in both groups during 1 to 4 months were independent of maternal vitamin D status and regimen. Both the mother and her infant attained improved vitamin D status and maintained normal [Ca].

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / blood
  • Bone Density Conservation Agents / metabolism
  • Calcium / blood
  • Calcium / metabolism*
  • Calcium / urine
  • Creatinine / urine
  • Dietary Supplements
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena / physiology*
  • Infant, Newborn
  • Lactation / metabolism
  • Maternal Nutritional Physiological Phenomena / physiology*
  • Milk, Human / chemistry*
  • Nutritional Requirements
  • Nutritional Status
  • Prospective Studies
  • Vitamin D / administration & dosage*
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood*
  • Vitamin D / metabolism
  • Vitamin D Deficiency / prevention & control

Substances

  • Bone Density Conservation Agents
  • Vitamin D
  • 25-hydroxyvitamin D
  • Creatinine
  • Calcium