Rickets in exclusively breast fed babies

Girish, Meenakshi; Subramaniam, Girish

doi:10.1007/s12098-008-0124-4

Cited by 14 publications

(8 citation statements)

References 5 publications

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“…1 In fact, when compared with formula-fed infants, solely breastfed infants are at increased risk of developing rickets. 2,3 This is especially true in African American breastfed infants. 4 Vitamin D activity in "normal" lactating women's milk is known to be in the range of 5 to 80 IU/L depending on the method of assay 1,5,6 ; however, the vitamin D content of human milk can be greatly increased by maternal oral vitamin D supplementation and/or increasing solar exposure of the mother.…”

Section: What This Study Addsmentioning

confidence: 99%

Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial

et al. 2015

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OBJECTIVE: Compare effectiveness of maternal vitamin D 3 supplementation with 6400 IU per day alone to maternal and infant supplementation with 400 IU per day.METHODS: Exclusively lactating women living in Charleston, SC, or Rochester, NY, at 4 to 6 weeks postpartum were randomized to either 400, 2400, or 6400 IU vitamin D 3 /day for 6 months. Breastfeeding infants in 400 IU group received oral 400 IU vitamin D 3 /day; infants in 2400 and 6400 IU groups received 0 IU/day (placebo). Vitamin D deficiency was defined as 25-hydroxy-vitamin D (25(OH)D) ,50 nmol/L. 2400 IU group ended in 2009 as greater infant deficiency occurred. Maternal serum vitamin D, 25(OH)D, calcium, and phosphorus concentrations and urinary calcium/creatinine ratios were measured at baseline then monthly, and infant blood parameters were measured at baseline and months 4 and 7.RESULTS: Of the 334 mother-infant pairs in 400 IU and 6400 IU groups at enrollment, 216 (64.7%) were still breastfeeding at visit 1; 148 (44.3%) continued full breastfeeding to 4 months and 95 (28.4%) to 7 months. Vitamin D deficiency in breastfeeding infants was greatly affected by race. Compared with 400 IU vitamin D 3 per day, 6400 IU/day safely and significantly increased maternal vitamin D and 25(OH)D from baseline (P , .0001). Compared with breastfeeding infant 25(OH)D in the 400 IU group receiving supplement, infants in the 6400 IU group whose mothers only received supplement did not differ. CONCLUSIONS:Maternal vitamin D supplementation with 6400 IU/day safely supplies breast milk with adequate vitamin D to satisfy her nursing infant's requirement and offers an alternate strategy to direct infant supplementation. WHAT'S KNOWN ON THIS SUBJECT:The vitamin D concentration in breast milk of women taking 400 IU vitamin D per day is relatively low, leading to vitamin D deficiency in breastfeeding infants. As a result, the American Academy of Pediatrics recommends breastfeeding infant vitamin D supplementation within days after birth. WHAT THIS STUDY ADDS:Maternal vitamin D supplementation alone with 6400 IU/day safely supplies breast milk with adequate vitamin D to satisfy the requirement of her nursing infant and offers an alternate strategy to direct infant supplementation. Dr Hollis, as the principal investigator (PI) of the project, worked with Dr Wagner in the conception of the project, study design, implementation of the study, laboratory analyses, data analyses, and writing of the manuscript; Dr, Wagner as clinical PI of the study, worked with Drs Hollis and Howard, site PI at the University of Rochester (U of R), and all other coinvestigators in the conception of the project, study design, implementation of the study, review of clinical and laboratory data, subject safety, data analyses, and writing of the manuscript; Dr Howard as clinical site PI at the U of R worked directly with Dr Wagner; she was involved in the conception of the project, study design, implementation of the study, laboratory analyses, data analyses, and writing of the manuscript; M...

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Section: What This Study Addsmentioning

confidence: 99%

Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial

et al. 2015

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“…Vitamin D deficiency can lead to hypocalcaemic seizures, rickets and gross motor delay during infancy and early childhood. [1][2][3][4] Rickets is one of the most common non-communicable diseases in children in the developing world, and has been on the rise in industrialised countries. 5 Associations between vitamin D deficiency, the development of Type I diabetes, multiple sclerosis, the onset of childhood allergies and respiratory tract infections have also been proposed.…”

Section: What This Paper Addsmentioning

confidence: 99%

“…Vitamin D deficiency can lead to hypocalcaemic seizures, rickets and gross motor delay during infancy and early childhood . Rickets is one of the most common non‐communicable diseases in children in the developing world, and has been on the rise in industrialised countries .…”

mentioning

confidence: 99%

Vitamin D in newborns. A randomised controlled trial comparing daily and single oral bolus vitamin D in infants

Huynh

Liew

et al. 2016

J Paediatrics Child Health

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“…Despite the modernization of India and adoption of many Western practices, breastfeeding practices remain unchanged and its use is preferred by the vast majority of Indian women [50,51]. However, exclusive breastfeeding by mothers who are vitamin D deficient can lead to higher incidence of infantile or nutritional rickets characterized by stunted growth, protruding abdomen, bowlegs and knock-kneed legs [52]. Poor vitamin D status in infants has also been linked to infections and impaired immune functions [53] as well as asthma and respiratory infections [54,55].…”

Section: Evidence Of Widespread Vitamin D Deficiency In Exclusively Bmentioning

confidence: 99%

“…It is possible to prevent vitamin D deficiency by supplementing the infants with 200 IU (5 mg) vitamin D/day [71]. Widespread practice of exclusive breastfeeding in India clearly contributes to greater vitamin D deficiency in infants [50,52], particularly when the mothers or infants are not supplemented with vitamin D. Evidence for the adverse effects of unsupplemented exclusive breastfeeding to vitamin D status in Indian populations residing in India or other sunny Near East countries is summarized in Table 4. The growing evidence for increased vitamin D deficiency in infants manifested as rickets or other bone deformities will hopefully motivate the policy makers to initiate much needed guidelines for vitamin D supplementation and/or fortification.…”

Section: Evidence Of Widespread Vitamin D Deficiency In Exclusively Bmentioning

confidence: 99%

Modern India and the vitamin D dilemma: Evidence for the need of a national food fortification program

Babu

Calvo

2010

Molecular Nutrition Food Res

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India is located between 8.4 and 37.6 degrees N latitude with the majority of its population living in regions experiencing ample sunlight throughout the year. Historically, Indians obtained most of their vitamin D through adequate sun exposure; however, darker skin pigmentation and the changes which have accompanied India's modernization, including increased hours spent working indoors and pollution, limit sun exposure for many. Inadequate sun exposure results in reduced vitamin D synthesis and ultimately poor vitamin D status if not compensated by dietary intake. Dietary vitamin D intake is very low in India because of low consumption of vitamin D rich foods, absence of fortification and low use of supplements. All these factors contribute to poor vitamin D status as measured by low circulating levels of 25-hydroxy vitamin D. Our review searches the published literature specific to India for evidence that would confirm the need to fortify food staples with vitamin D or stimulate public health policies for vitamin D supplementation and dietary guidelines tailored to the Indian diet. This review documents findings of widespread vitamin D deficiency in Indian populations in higher and lower socioeconomic strata, in all age groups, in both genders and people in various professions. Moreover, poor vitamin D status in India is accompanied by increased bone disorders including osteoporosis, osteomalacia in adults and rickets and other bone deformities in children. Without a concerted national effort to screen for vitamin D status, to implement policies or guidelines for vitamin D fortification and/or supplementation and to re-assess recommended dietary intake guidelines, dramatic increase in the number of bone disorders and other diseases may lie ahead.

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Rickets in exclusively breast fed babies

Cited by 14 publications

References 5 publications

Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial

Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial

Vitamin D in newborns. A randomised controlled trial comparing daily and single oral bolus vitamin D in infants

Modern India and the vitamin D dilemma: Evidence for the need of a national food fortification program

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