Vitamin D during lactation – range from 4,000 IU daily to 150,000 IU monthly

Created September 2018

Maternal Supplementation of Vitamin D During Lactation to Support Infant Vitamin D Needs: A Systematic Review

Open Journal of Pediatrics, 8, 255-272, September 2018, DOI: 10.4236/ojped.2018.83027

Kelly Schossow1, Alena M. Clark2, Mary A. Harris3*

1Jefferson County Public Health, Lakewood, CO, USA.

2 Department of Nutrition and Dietetics, University of Northern Colorado, Greeley, CO, USA.

3 Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.

This study looked at 7 Randomized Controlled Trials to determin how much the mother should take to get a good level of vitamin D for both the mother and exclusively breastfed infant. --- There have been hundreds of other studies looking at dosing size and interval * * Intervention category listing has items all trials * Intervention - non daily category listing has items along with related searches * Interval summary: Daily dosing down to just 1 dose every 17 days does not appear to matter much * Several trials, however, found that biweekly dosing was actually better than daily dosing * There is a slight decrease with monthly dosing * VitaminDWiki recommends a minimum of 50,000 IU every 2 weeks for everyone * infant will also need at least 200 IU daily average (or 2800 IU every 2 weeks) * Including Before, During, and After pregnancy (see below) * Infant-Child category listing has items along with related searches** * No consensus as to how much the infant needs: 200 IU up to 1,600 IU daily * Breast milk resulted in 20 ng of vitamin D for infant if mother had taken 5,000 IU daily – RCT Dec 2013 * 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 * Breastfeeding mothers and Vitamin D: supplement only themselves usually, 4 out of 10 used monthly rather than daily – Jan 2017 * 4,000 IU of Vitamin D is OK - 19 organizations agree - 2018 * General agreement that 4,000 IU is acceptable most places around the world --- 1. Pregnancy category starts with {include} --- 1. Healthy pregnancies need lots of vitamin D has the following summary {include}

📄 Download the PDF from VitaminDWiki

Human milk is generally considered to be insufficient in vitamin D. However, research completed in the 1980s showed that the vitamin D content of human milk is directly related to maternal serum vitamin D levels and therefore may potentially be adequate if the mother’s vitamin D levels are sufficient. Approximately one-third of the adult population, which includes breastfeeding women, in the United States have vitamin D insufficiency or deficiency. Among infants, 90.4% of breastfed infants are vitamin D deficient compared to 15.4% of formula fed infants. The American Academy of Pediatrics (AAP) has therefore recommended all breastfed infants be directly supplemented with 400 IU per day of vitamin D to decrease the risk of vitamin D insufficiency and rickets. According to the AAP, compliance rates with this recommendation ranges between 2% - 36%. Because the recommendation to supplement may undermine breastfeeding, many pediatricians do not inform their patients of the need to supplement. Additionally, some parents are concerned about directly supplementing their infant as risks may include allergic reactions to the ingredients, aspiration pneumonia, accidental overdose, and changes in intestinal flora and pH which may compromise the immune benefits of human milk. A literature review was conducted to examine the effect of maternal supplementation with vitamin D during lactation on human milk vitamin D content and maternal and infant serum vitamin D levels. Although there is no current consensus regarding dosage and timing of maternal vitamin D supplementation, the literature suggests that high-dose vitamin D supplementation of the lactating mother is as effective at maintaining infant vitamin D levels as direct infant supplementation, while also correcting the mother’s vitamin D deficiency.

Tags: Pregnancy