Maternal vitamin D₃ supplementation at 50 μg/d protects against low serum 25-hydroxyvitamin D in infants at 8 wk of age: a randomized controlled trial of 3 doses of vitamin D beginning in gestation and continued in lactation.
Am J Clin Nutr. 2015 Aug;102(2):402-10. doi: 10.3945/ajcn.114.106385. Epub 2015 Jul 8.
March KM1, Chen NN1, Karakochuk CD1, Shand AW2, Innis SM3, von Dadelszen P4, Barr SI1, Lyon MR5, Whiting SJ6, Weiler HA7, Green TJ8.
1 Food, Nutrition and Health.
2 Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, Australia;
3 Department of Paediatrics, and.
4 Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada;
5 Canadian Center for Functional Medicine, Coquitlam, Canada;
6 College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada; and.
7 School of Dietetics and Human Nutrition, McGill University, Montréal, Canada.
8 Food, Nutrition and Health, tim.green at ubc.ca.
Vitamin D supplementation is recommended for breastfed infants. Maternal supplementation beginning in gestation is a potential alternative, but its efficacy in maintaining infant 25-hydroxyvitamin D [25(OH)D] concentration after birth is unknown.
We determined the effect of 3 doses of maternal vitamin D supplementation beginning in gestation and continued in lactation on infant serum 25(OH)D and compared the prevalence of infant serum 25(OH)D cutoffs (>30, >40, >50, and >75 nmol/L) by dose at 8 wk of age.
Pregnant women (n = 226) were randomly allocated to receive 10, 25, or 50 μg vitamin D₃/d from 13 to 24 wk of gestation until 8 wk postpartum, with no infant supplementation. Mother and infant blood was collected at 8 wk postpartum.
At 8 wk postpartum, mean [nmol/L (95% CI)] infant 25(OH)D at 8 wk was higher in the 50-μg/d [75 (67, 83)] than in the 25-μg/d 52 (45, 58) or 10-μg/d [45 (38, 52)] vitamin D groups (P < 0.05). Fewer infants born to mothers in the 50-μg/d group had a 25(OH)D concentration <30 nmol/L (indicative of deficiency) than infants in the 25- and 10-μg/d groups, respectively (2% compared with 16% and 43%; P < 0.05). Fewer than 15% of infants in the 10- or 25-μg/d groups achieved a 25(OH)D concentration >75 nmol/L compared with 44% in the 50-μg/d group (P < 0.05). Almost all infants (∼98%, n = 44) born to mothers in the 50-μg/d group achieved a 25(OH)D concentration >30 nmol/L. At 8 wk postpartum, mean maternal 25(OH)D concentration was higher in the 50-μg/d [88 (84, 91)] than in the 25-μg/d [78 (74, 81)] or 10-μg/d [69 (66, 73)] groups (P < 0.05).
Maternal supplementation beginning in gestation with 50 μg vitamin D₃/d protects 98% of unsupplemented breastfed infants against 25(OH)D deficiency (<30 nmol/L) to at least 8 wk, whereas 10 or 25 μg vitamin D/d protects only 57% and 84% of infants, respectively.
- Pill also contained "250 mg calcium, 1000 μg folic acid, 27 mg iron, 1500 IU β-carotene, 1500 IU vitamin A, 3 mg thiamin, 3.4 mg riboflavin, 20 mg niacinamide, 10 mg vitamin B-6, 12 μg vitamin B-12, 10 mg pantothenic acid, 30 μg biotin, 100 mg vitamin C, 30 IU vitamin E, 50 mg magnesium, 5 mg potassium, 25 mg zinc, 1 mg manganese, 0.15 mg iodine, 2 mg copper, 25 μg chromium, 25 μg molybdenum, and 25 μg selenium."
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