Impact of Vitamin D Supplementation during Lactation on Vitamin D Status and Body Composition of Mother-Infant Pairs: A MAVID Randomized Controlled Trial

Abstract

ObjectiveThe optimal vitamin D intake for nursing women is controversial. Deterioration, at least in bone mass, is reported during lactation. This study evaluated whether vitamin D supplementation during lactation enhances the maternal and infant’s vitamin D status, bone mass and body composition.Design and MethodsAfter term delivery, 174 healthy mothers were randomized to receive 1200 IU/d (800 IU/d+400 IU/d from multivitamins) or 400 IU/d (placebo+400 IU/d from multivitamins) of cholecalciferol for 6 months while breastfeeding. All infants received 400 IU/d of cholecalciferol. Serum 25-hydroxyvitamin D [25(OH)D], iPTH, calcium, urinary calcium, and densitometry were performed in mother-offspring pairs after delivery, and at 3 and 6 months later.ResultsA total of 137 (79%) (n = 70; 1200 IU/d, n = 67; 400 IU/d) completed the study. 25(OH)D was similar in both groups at baseline (13.7 ng/ml vs. 16.1 ng/ml; P = 0.09) and at 3 months (25.7 ng/ml vs. 24.5 ng/ml; P = 0.09), but appeared higher in the 1200 IU/d group at 6 months of supplementation (25.6 ng/ml vs. 23.1 ng/ml; P = 0.009). The prevalence of 25(OH)D <20 ng/ml was comparable between groups at baseline (71% vs. 64%, P = 0.36) but lower in the 1200 IU/d group after 3 months (9% vs. 25%, P = 0.009) and 6 months (14% vs. 30%, P = 0.03). Maternal and infants’ iPTH, calciuria, bone mass and body composition as well as infants’ 25(OH)D levels were not significantly different between groups during the study. Significant negative correlations were noted between maternal 25(OH)D and fat mass (R = −0.49, P = 0.00001), android fat mass (R = −0.53, P = 0.00001), and gynoid fat mass (R = −0.43, P = 0.00001) after 6 months of supplementation.ConclusionsVitamin D supplementation at a dose of 400 IU/d was not sufficient to maintain 25(OH)D >20 ng/ml in nursing women, while 1200 IU/d appeared more effective, but had no effect on breastfed offspring vitamin D status, or changes in the bone mass and the body composition observed in both during breastfeeding.Trial RegistrationClinicalTrials.gov NCT01506557

Calcium Plus Vitamin D Supplementation During the Third Trimester of Pregnancy in Adolescents Accustomed to Low Calcium Diets Does Not Affect Infant Bone Mass at Early Lactation in a Randomized Controlled Trial ,

“…Few studies have evaluated infant bone mass by using DXA during the first year of life (3,8,9,34,35), and there is no published information on bone measurements of Brazilian infants. Although the task was challenging, we obtained DXA measurements during the first 5 wk postpartum from all 56 infants in this study.…”

Vitamin D supplementation guidelines for Poland – a 2018 update

“…MŁODZIEŻ (11)(12)(13)(14)(15)(16)(17)(18) • u zdrowych nastolatków przebywających na słońcu z odkrytymi przedramionami i podudziami przez co najmniej 15 minut w godzinach od 10.00 do 15.00 bez kremów z filtrem w okresie od maja do września suplementacja nie jest konieczna, choć wciąż zalecana i bezpieczna (1⊕⊕⊕); • jeżeli powyższe warunki nie są spełnione, zalecana jest suplementacja w dawce 800-2000 IU/dobę, w zależności od masy ciała i podaży witaminy D w diecie, przez cały rok (1⊕⊕⊕).…”

Optimal nutrition in lactating women and its effect on later health of offspring: A systematic review of current evidence and recommendations (EarlyNutrition project)

“…The one publication on vitamin D intake during lactation referred to the EarlyNutrition outcome overweight/obesity, and was a prospective, double blinded, randomized controlled trial of vitamin D supplementation during lactation in both mother and infant (Czech-Kowalska et al, 2014).…”