A Randomized Trial Evaluating the Effect of 2 Regimens of Maternal Vitamin A Supplementation on Breast Milk Retinol Levels

Abstract

The aim of this study was to assess the effect of 2 different megadoses of retinyl palmitate on the level of retinol in the breast milk of healthy women. In total, 199 women were randomly allocated to 3 groups and supplemented in the postpartum period with a single retinyl palmitate dose of 200 000 IU (S1), a double dose of 200 000 IU 24 hours apart (S2), or no supplementation (C). Retinol content of colostrum and mature milk at 4 weeks was determined by high-performance liquid chromatography (HPLC). For colostrum, no significant difference was found between the groups (P = .965). The retinol content in mature milk differed between group C and groups S1 and S2 (P < .05). The double dose of vitamin A did not significantly increase the retinol content of milk at 4 weeks postpartum in comparison to a single dose; however, future research is needed to determine the optimal timing of the second dose of vitamin A.

Effect of maternal vitamin A supplementation on retinol concentration in colostrum

“…5 A suplementação materna com vitamina A no pós-parto imediato tem sido uma intervenção amplamente utilizada em áreas de alto risco para a deficiência desta vitamina, e estudos indicam que esta intervenção resulta em um aumento no retinol do leite materno. 23 Essas diferenças podem ter ocorrido devido ao maior número amostral nos estudos mencionados e ao fato de a concentração de retinol no leite ter sido expressa como média e desvio-padrão, por apresentar aderência à distribuição normal. 22 No leite colostro, os níveis de retinol em condições de jejum antes da suplementação foram inferiores aos de mulheres do Nordeste brasileiro (100,3 g/dL) 22 e de Bangladesh.…”

Evaluating Sweet Potato as an Intervention Food to Prevent Vitamin A Deficiency

“…VA deficiency is usually prevented by distributing high‐dose VA supplements twice yearly (Pedro and others 2004; Aguayo and others 2005; Donnen and others 2007; Idindili and others 2007; Bezerra and others 2010). VA supplementation programs can be cost‐effective nutrient interventions and, therefore, are supported by several national governments and international charitable organizations.…”

Suplementação com vitamina A em gestantes e puérperas brasileiras: uma revisão sistemática

“…The lowest maternal deficiency percentage was seen in group S2 (20.7%), compared with groups S1 (34.5%) and C (46.7%); group S2 was considered moderately deficient, while groups S1 and C, very deficient. In this study, the analyzed variables -vitamin A consumption adaptation, food origin (animal or vegetal), maternal age, number of deliveries, anthropometric nutritional status, gestational hemoglobin, kind of delivery, and newborn gender-were not associated with retinol content in the milk 16 .…”

“…Table 1 summarizes the characteristics of the included articles, with regard to the place of performance, the moment when the intervention was conducted, the doses of administered supplements, the number of participants in each study, the main results, and the evaluation of manuscript quality (two studies 19,20 reached a score above 3). Five articles described a randomization performance in the distribution of participants to intervention groups in their methods 12,[16][17][18][19][20] . The studies performed by Fernandes et al 19 , Santos et al 20 , and Martins et al 21 used the term "double-blind"; the studies of Bezerra et al 16 , Fernandes et al 19 , Santos et al 20 , and Martins et al 21 presented information regarding losses and their causes.…”

“…The study showed that the maternal supplementation with 200,000 IU of retinol palmitate in the immediate postpartum and the promotion of breastfeeding practices are efficient to improve vitamin A nutritional status for the mother-child binomial 12 . In another study, Bezerra et al 16 evaluated the effect of two large different doses of retinol palmitate on retinol contents in the breast milk of healthy women. The sample comprised 199 puerperal women until 16 hours after delivery.…”