Maternal Vitamin D Supplementation to Improve the Vitamin D Status of Breast-Fed Infants: A Randomized Controlled Trial

Mayo Clin Proc. 2013 Dec;88(12):1378-87. doi: 10.1016/j.mayocp.2013.09.012.

Abstract

Objective: To determine whether a single monthly supplement is as effective as a daily maternal supplement in increasing breast milk vitamin D to achieve vitamin D sufficiency in their infants.

Patients and methods: Forty mothers with exclusively breast-fed infants were randomized to receive oral cholecalciferol (vitamin D3) 5000 IU/d for 28 days or 150,000 IU once. Maternal serum, breast milk, and urine were collected on days 0, 1, 3, 7, 14, and 28; infant serum was obtained on days 0 and 28. Enrollment occurred between January 7, 2011, and July 29, 2011.

Results: In mothers given daily cholecalciferol, concentrations of serum and breast milk cholecalciferol attained steady levels of 18 and 8 ng/mL, respectively, from day 3 through 28. In mothers given the single dose, serum and breast milk cholecalciferol peaked at 160 and 40 ng/mL, respectively, at day 1 before rapidly declining. Maternal milk and serum cholecalciferol concentrations were related (r=0.87). Infant mean serum 25-hydroxyvitamin D concentration increased from 17±13 to 39±6 ng/mL in the single-dose group and from 16±12 to 39±12 ng/mL in the daily-dose group (P=.88). All infants achieved serum 25-hydroxyvitamin D concentrations of more than 20 ng/mL.

Conclusion: Either single-dose or daily-dose cholecalciferol supplementation of mothers provided breast milk concentrations that result in vitamin D sufficiency in breast-fed infants.

Clinical trial registration: clinicaltrials.gov NCT01240265.

Keywords: 1,25(OH)(2)D; 1,25-dihydroxyvitamin D; 25(OH)D; 25-hydroxyvitamin D; AAP; American Academy of Pediatrics; IOM; Institute of Medicine.

Publication types

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

MeSH terms

  • Adult
  • Breast Feeding*
  • Cholecalciferol / administration & dosage*
  • Cholecalciferol / blood
  • Cholecalciferol / metabolism*
  • Cholecalciferol / urine
  • Dietary Supplements*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Lactation
  • Male
  • Milk, Human / metabolism*
  • Mothers*
  • Time Factors
  • Treatment Outcome
  • Vitamin D Deficiency / drug therapy*
  • Vitamin D Deficiency / prevention & control
  • Vitamins / administration & dosage*
  • Vitamins / blood
  • Vitamins / metabolism*
  • Vitamins / urine

Substances

  • Vitamins
  • Cholecalciferol

Associated data

  • ClinicalTrials.gov/NCT01240265