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Breast milk resulted in 20 ng of vitamin D for infant if mother had taken 5,000 IU daily – RCT Dec 2013

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 , Pages 1378-1387, December 2013
Sara S. Oberhelman, MD Oberhelman.sara at mayo.edu, Michael E. Meekins, PharmD, Philip R. Fischer, MD , Bernard R. Lee, PharmD , Ravinder J. Singh, PhD , Stephen S. Cha, MS , Brian M. Gardner, PharmD , John M. Pettifor, MB, BCh, PhD , Ivana T. Croghan, PhD , Tom D. Thacher, MD

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.

clinicaltrials.gov NCT01240265

Summaries by VitaminDWiki

Peaks of single dose were 4X less in breast milk

Serum 160 ng
Breast milk 40 ng

Dose to motherInfant @ 30 days
5,000 IU daily 39.2 ng
150,000 IU monthly38.7 ng

See also VitaminDWiki

see wikipage http://www.vitamindwiki.com/tiki-index.php?page_id=2475

Healthy pregnancies need lots of vitamin D has the following summary

Vit. D
0. Chance of not conceiving3.4 times Observe
1. Miscarriage 2.5 times Observe
2. Pre-eclampsia 3.6 timesRCT
3. Gestational Diabetes 3 times RCT
4. Good 2nd trimester sleep quality 3.5 times Observe
5. Premature birth 2 times RCT
6. C-section - unplanned 1.6 timesObserve
     Stillbirth - OMEGA-3 4 timesRCT - Omega-3
7. Depression AFTER pregnancy 1.4 times RCT
8. Small for Gestational Age 1.6 times meta-analysis
9. Infant height, weight, head size
     within normal limits
10. Childhood Wheezing 1.3 times RCT
11. Additional child is Autistic 4 times Intervention
12.Young adult Multiple Sclerosis 1.9 timesObserve
13. Preeclampsia in young adult 3.5 timesRCT
14. Good motor skills @ age 31.4 times Observe
15. Childhood Mite allergy 5 times RCT
16. Childhood Respiratory Tract visits 2.5 times RCT

RCT = Randomized Controlled Trial


  • Dawodu A, Agarwal M, Hossain M, Kochiyil J, Zayed R. Hypovitaminosis D and vitamin D deficiency in exclusively breast-feeding infants and their mothers in summer: a justification for vitamin D supplementation of breast-feeding infants. J Pediatr. 2003;142(2):169–173
  • Merewood A, Mehta SD, Grossman X, et al. Vitamin D status among 4-month-old infants in New England: a prospective cohort study. J Hum Lact. 2012;28(2):159–166
  • Greer FR. 25-Hydroxyvitamin D: functional outcomes in infants and young children. Am J Clin Nutr. 2008;88(2):529S–533S
  • Thacher TD, Fischer PR, Tebben PJ, et al. Increasing incidence of nutritional rickets: a population based study in Olmsted County, Minnesota. Mayo Clin Proc. 2013;88(2):176–183
  • Scanlon KS. Vitamin D Expert Panel Meeting. October 2001. http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/Vitamin_D_Expert_Panel_Meeting.pdf. Accessed September 5, 2012.
  • Zipitis CS, Akobeng AK. Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and meta-analysis. Arch Dis Child. 2008;93(6):512–517
  • Camargo CA, Ganmaa D, Frazier AL, et al. Randomized trial of vitamin D supplementation and risk of acute respiratory infection in Mongolia. Pediatrics. 2012;130(3):e561–e567
  • Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Clin Proc. 2011;86(1):50–60
  • Rovner AJ, O’Brien KO. Hypovitaminosis D among healthy children in the United States: a review of the current evidence. Arch Pediatr Adolesc Med. 2008;162(6):513–519
  • Seth A, Marwaha RK, Singla B, et al. Vitamin D nutritional status of exclusively breast fed infants and their mothers. J Pediatr Endocrinol Metab. 2009;22(3):241–246
  • Ziegler EE, Hollis BW, Nelson SE, Jeter JM. Vitamin D deficiency in breastfed infants in Iowa. Pediatrics. 2006;118(2):603–610
  • American Academy of Pediatrics, Committee on Environmental Health. Ultraviolet light: a hazard to children. Pediatrics. 1999;104(2, pt 1):328–333
  • Yetley EA. Assessing the vitamin D status of the US population. Am J Clin Nutr. 2008;88(2):558S–564S
  • U. Preventative Services Task Force website. Primary care interventions to promote breastfeeding: clinical summary. AHRQ Publication No 09-05126-EF-3. October 2008. http://www.uspreventitiveservicestaskforce.org/uspstf2008/breastfeeding/brfeedsum.htm. Accessed September 5, 2012.
  • U Department of Health and Human Services. Healthy People 2010. Washington, DC: U Government Printing Office; 2000;
  • Hollis BW, Roos BA, Draper HH, Lambert PW. Vitamin D and its metabolites in human and bovine milk. J Nutr. 1981;111(7):1240–1248
  • Reeve LE, Chesney RW, DeLuca HF. Vitamin D of human milk: identification of biologically active forms. Am J Clin Nutr. 1982;36(1):122–126
  • Dawodu A, Tsang RC. Maternal vitamin D status: effect on milk vitamin D content and vitamin D status of breastfeeding infants. Adv Nutr. 2012;3(3):353–361
  • Taylor JA, Geyer LJ, Feldman KW. Use of supplemental vitamin D among infants breastfed for prolonged periods. Pediatrics. 2010;125(1):105–111
  • Perrine CG, Sharma AJ, Jefferds ME, Serdula MK, Scanlon KS. Adherence to vitamin D recommendations among US infants. Pediatrics. 2010;125(4):627–632
  • Pepper KJ, Judd SE, Nanes MS, Tangpricha V. Evaluation of vitamin D repletion regimens to correct vitamin D status in adults. Endocr Pract. 2009;15(2):95–103
  • Binkley N, Gemar D, Engelke J, et al. Evaluation of ergocalciferol or cholecalciferol dosing, 1,600 IU daily or 50,000 IU monthly in older adults. J Clin Endocrinol Metab. 2011;96(4):981–988
  • Gordon CM, Williams AL, Feldman HA, et al. Treatment of hypovitaminosis D in infants and toddlers. J Clin Endocrinol Metab. 2008;93(7):2716–2721
  • Shah BR, Finberg L. Single-day therapy for nutritional vitamin D-deficiency rickets: a preferred method. J Pediatr. 1994;125(3):487–490
  • Thacher TD, Fischer PR, Pettifor JM, et al. A comparison of calcium, vitamin D, or both for nutritional rickets in Nigerian children. N Engl J Med. 1999;341(8):563–568
  • Hollis BW, Wagner CL. Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Clin Nutr. 2004;80(6, suppl):1752S–1758S
  • Basile LA, Taylor SN, Wagner CL, Horst RL, Hollis BW. 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. 2006;1(1):27–35
  • Wagner CL, Hulsey TC, Fanning D, Ebeling M, Hollis BW. High-dose vitamin D3 supplementation in a cohort of breastfeeding mothers and their infants: a 6-month follow-up pilot study. Breastfeed Med. 2006;1(2):59–70
  • Kovacs CS. Vitamin D in pregnancy and lactation: maternal, fetal, and neonatal outcomes from human and animal studies. Am J Clin Nutr. 2008;88(2):520S–528S
  • Hollis BW, Wagner CL. The vitamin D requirement during human lactation: the facts and IOM’s ‘utter’ failure. Public Health Nutr. 2011;14(4):748–749
  • Singh RJ. Quantitation of 25-OH-vitamin D (25OHD) using liquid tandem mass spectrometry (LC-MS-MS). Methods Mol Biol. 2010;603:509–517
  • Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academies Press; 2011;
  • Ala-Houhala M, Koskinen T, Terho A, Koivula T, Visakorpi J. Maternal compared with infant vitamin D supplementation. Arch Dis Child. 1986;61(12):1159–1163
  • Kruk ME, Schwalbe N. The regulation between intermittent dosing and adherence: preliminary insights. Clin Ther. 2006;28(12):1989–1995
  • Hollis BW. Individual quantitation of vitamin D2, vitamin D3, 25-hydroxyvitamin D2, and 25-hydroxyvitamin D3 in human milk. Anal Biochem. 1983;131(1):211–219
  • Ala-Houhala M, Koskinen T, Parviainen MT, Visakorpi JK. 25-Hydroxyvitamin D and vitamin D in human milk: effects of supplementation and season. Am J Clin Nutr. 1988;48(4):1057–1060
  • Hollis BW, Pittard WB, Reinhardt TA. Relationships among vitamin D, 25-hydroxyvitamin D, and vitamin D-binding protein concentrations in the plasma and milk of human subjects. J Clin Endocrinol Metab. 1986;62(1):41–44
  • Thandrayen K, Pettifor JM. Maternal vitamin D status: implications for the development of infantile nutritional rickets. Endocrinol Metab Clin North Am. 2010;39(2):303–320
  • Kalkwarf HJ, Specker BL, Bianchi DC, Ranz J, Ho M. The effect of calcium supplementation on bone density during lactation and after weaning. N Engl J Med. 1997;337(8):523–528
  • Tang J, McFann KK, Chonchol MB. Association between serum 25-hydroxyvitamin D and nephrolithiasis: the National Health and Nutrition Examination Survey III, 1988-94. Nephrol Dial Transplant. 2012;27(12):4385–4389
  • Heaney RP, Armas LA, Shary JR, Bell NH, Binkley N, Hollis BW. 25-Hydroxylation of vitamin D3: relation to circulating vitamin D3 under various input conditions. Am J Clin Nutr. 2008;87(6):1738–1742