Nutritional Status of Vitamin D and the Effect of Vitamin D Supplementation in Korean Breast-fed Infants

Abstract

We investigated the vitamin D status and the effect of vitamin D supplementation in Korean breast-fed infants. The healthy term newborns were divided into 3 groups; A, formula-fed; B, breast-fed only; S, breast-fed with vitamin D supplementation. We measured serum concentrations of vitamin D (25OHD3), calcium (Ca), phosphorus (P), alkaline phosphatase (AP), intact parathyroid hormone (iPTH) and bone mineral density (BMD) at 6 and 12 months of age. Using questionnaires, average duration of sun-light exposure and dietary intake of vitamin D, Ca and P were obtained. At 6 and 12 months of age, 25OHD3 was significantly higher in group S than in group B (P<0.001). iPTH was significantly lower in group S than in group B at 6 months (P=0.001), but did not differ at 12 months. Regardless of vitamin D supplementation, BMD was lower in group B and S than in group A (P<0.05). Total intake of vitamin D differed among 3 groups (P<0.001, A>S>B), but total intake of Ca and P were higher in group A than in group B and S (P<0.001). In conclusion, breast-fed infants show lower vitamin D status and bone mineralization than formula-fed infants. Vitamin D supplementation (200 IU/day) in breast-fed infants increases serum 25-OH vitamin D3, but not bone mineral density.

Effect of Breastfeeding on Serum Osteoprotegerin and Soluble Receptor Activator of Nuclear Factor-Kappa B Ligand in Full Term Neonates

“…They reported that the release of proinflammatory cytokines such as TNFα by immunocompetent cells does not differ significantly in breastfed and formula-fed infants, despite differences in cell membrane fatty acid composition (20). Although the levels of serum Ca 2+ , P concentrations and the activity of ALP in the present study confirmed the finding of the others, some investigator reported that there are no statistically significant differences among breast and formula feeding infants in serum Ca, P, and ALP at birth, and also serum Ca and ALP were not different in the two groups at 6 and 12 months of ages (21, 22). Further studies with a larger sample size are required to confirm these findings.…”

Can vitamin D status be assessed by serum 25OHD in children?

“…Values of serum 25OHD less than 20 ng/ml [21][22][23][24] and less than 10 ng/ml [12,[25][26][27][28][29] were taken as cut-off thresholds indicative of vitamin D deficiency.…”

Vitamin D and skeletal health in infancy and childhood

“…Four intervention studies of vitamin D supplementation in breast-fed infants have reported outcomes related to bone mineralisation. In all but one study [84], serum 25(OH)D was greater in the supplemented infants, but no differences in BMC or BMD were identified at 3 months [85], 6 months [86] or 12 months [86,87] of age. In one study a significantly greater distal radius BMC measured by single photon absorptiometry was measured in the supplemented infants at 12 weeks of age, but not at 26 weeks of age [84].…”