Clare R Wall1, Alistair W Stewart2, Carlos A Camargo3, Robert Scragg2, Edwin A Mitchell4, Alec Ekeroma5, Julian Crane6, Tania Milne4, Judy Rowden4, Ronald Horst7, Cameron C Grant8. 1. Discipline of Nutrition and Dietetics, c.wall@auckland.ac.nz. 2. School of Population Health. 3. Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA; 4. Department of Pediatrics: Child & Youth Health, and. 5. Obstetrics & Gynecology, University of Auckland, Auckland, New Zealand; 6. Medicine, University of Otago, Wellington, New Zealand; 7. Heartland Assays LLC, Ames, IA; and. 8. Department of Pediatrics: Child & Youth Health, and Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand.
Abstract
BACKGROUND: Human milk is typically low in vitamin D activity (VDA). Whether the vitamin D content of breast milk at birth can be increased by supplementing the mother during pregnancy has not been reported to the best of our knowledge. OBJECTIVE: We examined the effect of vitamin D supplementation during pregnancy on breast-milk VDA in the first 2 mo of lactation. DESIGN: Breast-milk samples were obtained from women who were enrolled in a randomized, double-blinded, placebo-controlled trial of vitamin D supplementation during pregnancy. Pregnant women were enrolled at 27 wk of gestation and randomly assigned to the following 3 groups: a placebo group, a group who received one dosage of daily oral vitamin D3 (1000 IU), or a group who received 2 dosages of daily oral vitamin D3 (2000 IU). Serum 25-hydroxyvitamin D [25(OH)D] was measured at enrollment, at 36 wk of gestation, and in cord blood at birth. Study participants who were breastfeeding were invited to provide breast-milk samples forVDA measurement [concentration of vitamin D2, vitamin D3, 25(OH)D2, and 25(OH)D3] at 2 wk and 2 mo postpartum. A linear mixed model was used to compare breast-milk VDA between the 3 study groups. RESULTS: A total of 75 women provided breast-milk samples (44 women provided breast-milk samples at both 2 wk and 2 mo postpartum). The mean (95% CI) VDA at age 2 wk was 52 IU/L (12, 217 IU/L) in the placebo group, 51 IU/L (17, 151 IU/L) in the 1000-IU group, and 74 IU/L (25, 221 IU/L) in the 2000-IU group; and at age 2 mo, the mean (95% CI) VDA was 45 IU/L (16, 124 IU/L), 43 IU/L (18, 103 IU/L), and 58 IU/L (15, 224 IU/L), respectively. There was no significant interaction in VDA between the sample-collection time and treatment (P = 0.61), but there was a difference between lower- and higher-dosage treatment groups (P = 0.04). CONCLUSION:Maternal vitamin D supplementation during pregnancy of 2000 IU/d (compared with 1000 IU/d and with a placebo) results in a higher VDA of breast milk ≥2 mo postpartum. This trial was registered at the Australian New Zealand Clinical Trials Registry as ACTRN12610000483055.
RCT Entities:
BACKGROUND:Human milk is typically low in vitamin D activity (VDA). Whether the vitamin D content of breast milk at birth can be increased by supplementing the mother during pregnancy has not been reported to the best of our knowledge. OBJECTIVE: We examined the effect of vitamin D supplementation during pregnancy on breast-milk VDA in the first 2 mo of lactation. DESIGN: Breast-milk samples were obtained from women who were enrolled in a randomized, double-blinded, placebo-controlled trial of vitamin D supplementation during pregnancy. Pregnant women were enrolled at 27 wk of gestation and randomly assigned to the following 3 groups: a placebo group, a group who received one dosage of daily oral vitamin D3 (1000 IU), or a group who received 2 dosages of daily oral vitamin D3 (2000 IU). Serum 25-hydroxyvitamin D [25(OH)D] was measured at enrollment, at 36 wk of gestation, and in cord blood at birth. Study participants who were breastfeeding were invited to provide breast-milk samples for VDA measurement [concentration of vitamin D2, vitamin D3, 25(OH)D2, and 25(OH)D3] at 2 wk and 2 mo postpartum. A linear mixed model was used to compare breast-milk VDA between the 3 study groups. RESULTS: A total of 75 women provided breast-milk samples (44 women provided breast-milk samples at both 2 wk and 2 mo postpartum). The mean (95% CI) VDA at age 2 wk was 52 IU/L (12, 217 IU/L) in the placebo group, 51 IU/L (17, 151 IU/L) in the 1000-IU group, and 74 IU/L (25, 221 IU/L) in the 2000-IU group; and at age 2 mo, the mean (95% CI) VDA was 45 IU/L (16, 124 IU/L), 43 IU/L (18, 103 IU/L), and 58 IU/L (15, 224 IU/L), respectively. There was no significant interaction in VDA between the sample-collection time and treatment (P = 0.61), but there was a difference between lower- and higher-dosage treatment groups (P = 0.04). CONCLUSION: Maternal vitamin D supplementation during pregnancy of 2000 IU/d (compared with 1000 IU/d and with a placebo) results in a higher VDA of breast milk ≥2 mo postpartum. This trial was registered at the Australian New Zealand Clinical Trials Registry as ACTRN12610000483055.
Authors: Carol L Wagner; Thomas C Hulsey; Myla Ebeling; Judy R Shary; Golaleh Asghari; Cynthia R Howard; John E Baatz; Danforth A Newton; Amy E Wahlquist; Susan G Reed; Sarah N Taylor; Ruth A Lawrence; Bruce W Hollis Journal: Breastfeed Med Date: 2020-09-11 Impact factor: 1.817
Authors: Johanne Haugen; Manjeswori Ulak; Ram K Chandyo; Sigrun Henjum; Andrew L Thorne-Lyman; Per Magne Ueland; Øivind Midtun; Prakash S Shrestha; Tor A Strand Journal: Nutrients Date: 2016-12-21 Impact factor: 5.717
Authors: Johanne Haugen; Ram K Chandyo; Manjeswori Ulak; Maria Mathisen; Sudha Basnet; Karl A Brokstad; Palle Valentiner-Branth; Prakash S Shrestha; Tor A Strand Journal: Nutrients Date: 2017-01-17 Impact factor: 5.717
Authors: Stefan Pilz; Armin Zittermann; Rima Obeid; Andreas Hahn; Pawel Pludowski; Christian Trummer; Elisabeth Lerchbaum; Faustino R Pérez-López; Spyridon N Karras; Winfried März Journal: Int J Environ Res Public Health Date: 2018-10-12 Impact factor: 3.390
Authors: Cristina Palacios; Maria Angelica Trak-Fellermeier; Ricardo X Martinez; Lucero Lopez-Perez; Paul Lips; James A Salisi; Jessica C John; Juan Pablo Peña-Rosas Journal: Cochrane Database Syst Rev Date: 2019-10-03