Maternal Vitamin D Supplementation to Improve the Vitamin D Status of Breast-fed Infants: A Randomized Controlled Trial
Mayo Clinic Proceedings; Volume 88, Issue 12, December 2013, Pages 1378–1387
Sara S. Oberhelman, MDa, Corresponding author contact information, E-mail the corresponding author, Michael E. Meekins, PharmDb, Philip R. Fischer, MDc, Bernard R. Lee, PharmDb, Ravinder J. Singh, PhDd, Stephen S. Cha, MSe, Brian M. Gardner, PharmDb, John M. Pettifor, MB, BCh, PhDg, Ivana T. Croghan, PhDf, Tom D. Thacher, Mda
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.
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.
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.govNCT01240265
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- Vitamin D Before, During, and After Pregnancy - vs only immediately after pregnancy = this study
- Take vitamin D3 daily or weekly has the following notional graph for blood level of 30 ng