Effect of combined maternal and infant vitamin D supplementation on vitamin D status of exclusively breastfed infants |
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Authors: | Hussein F. Saadi Adekunle Dawodu Bachar Afandi Reem Zayed Sheela Benedict Nicolaas Nagelkerke Bruce W. Hollis |
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Affiliation: | Departments of Internal Medicine,;Community Medicine, Faculty of Medicine and Health Sciences, United Arab Emirates University,;Department of Internal Medicine, Tawam hospital,;Department of Preventive Medicine, Health Authority for Abu Dhabi, Al Ain, United Arab Emirates,;Center for Global Child Health, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, and;Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA |
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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: | vitamin D deficiency 25-hydroxyvitamin D breastfeeding women breastfed infants |
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