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Effect of combined maternal and infant vitamin D supplementation on vitamin D status of exclusively breastfed infants

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Abstract

Severe vitamin D deficiency in mothers and their breastfed infants is a significant health problem in the Middle East. Supplementation of the breastfed infant alone with the recommended dose of vitamin D may be insufficient in high-risk population. We investigated the effect of combined maternal and infant vitamin D supplementation on vitamin D status of the breastfed infant. We examined also the effect of supplementation on vitamin D antirachitic activity of breast milk in a subset of mothers. Healthy breastfeeding mothers (n = 90) were randomly assigned to 2000 IU daily (group 1) or 60 000 IU monthly (group 2) of vitamin D2, and all their infants (n = 92) received 400 IU daily of vitamin D2 for 3 months. Most infants had vitamin D deficiency – 25-hydroxyvitamin D [25(OH)D] ≤ 37.5 nmol L−1– at study entry. Serum 25(OH)D concentrations at 3 months increased significantly from baseline in infants of mothers in group 1 (13.9 ± 8.6 vs. 49.6 ± 18.5 nmol L−1, P < 0.0001) and group 2 (13.7 ± 12.1 vs. 44.6 ± 15.0 nmol L−1, P < 0.0001). Maternal and infant serum 25(OH)D concentrations correlated positively at baseline (r = 0.36, P = 0.01) and 3 months (r = 0.46, P = 0.002). Milk antirachitic activity increased from undetectable (<20 IU L−1) to a median of 50.9 IU L−1. In conclusion, combined maternal and infant vitamin D supplementation was associated with a threefold increase in infants’ serum 25(OH)D concentrations and a 64% reduction in the prevalence of vitamin D deficiency without causing hypervitaminosis D.
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Keywords: 25-hydroxyvitamin D; breastfed infants; breastfeeding women; vitamin D deficiency

Document Type: Research Article

Affiliations: 1: Departments of Internal Medicine, 2: Center for Global Child Health, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, and 3: Department of Internal Medicine, Tawam hospital, 4: Department of Preventive Medicine, Health Authority for Abu Dhabi, Al Ain, United Arab Emirates, 5: Community Medicine, Faculty of Medicine and Health Sciences, United Arab Emirates University, 6: Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA

Publication date: 2009-01-01

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