Safety Aspects of a Randomized Clinical Trial of Maternal and Infant Vitamin D Supplementation by Feeding Type Through 7 Months Postpartum

Substantial Vitamin D Supplementation Is Required during the Prenatal Period to Improve Birth Outcomes

“…The amount of vitamin D supplemented during pregnancy has long been a contentious subject due to the false association of vitamin D being a teratogen leading to Williams Syndrome [8,9]. This association, which is now known to be false, has caused generations of obstetricians and healthcare providers to fear vitamin D. Several studies have now clearly demonstrated vitamin D is safe at doses up to and exceeding 4400 IU/day [10][11][12][13][14][15][16][17][18][19][20][21][22][23]. In all of these studies, NOT A SINGLE ADVERSE EVENT has been associated with vitamin D supplementation [10][11][12][13][14][15][16][17][18][19][20][21][22][23].…”

“…This association, which is now known to be false, has caused generations of obstetricians and healthcare providers to fear vitamin D. Several studies have now clearly demonstrated vitamin D is safe at doses up to and exceeding 4400 IU/day [10][11][12][13][14][15][16][17][18][19][20][21][22][23]. In all of these studies, NOT A SINGLE ADVERSE EVENT has been associated with vitamin D supplementation [10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Thus, it is now known that this dose of vitamin D can be safely administered during pregnancy.…”

“…Many of these clinical trials have validated the positive effects of prenatal vitamin D on birth outcomes [13][14][15][19][20][21]24] while a few have not [23]. However, as mentioned previously, all have shown vitamin D supplementation up to 4400 IU/day during pregnancy to be safe [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”

Vitamin D: An Essential Micronutrient for Bone Health

“…Several trial studies of supplementing 4,000-6,400 IU vitamin D3 daily for 6 months in nursing mothers found that this is safe for mothers and provides adequate maternal vitamin D intake and higher maternal circulating 25(OH)D levels to meet infant requirements without adverse events. [27][28][29] The Endocrine Society recommends a daily intake of 4,000-6,000 IU of vitamin D for lactating mothers to satisfy the vitamin D requirement in breastfed infants. 30…”

“…6,23 However, due to the concern of sunburn and possible risk of skin cancer later in life, the AAP recommendations in 1999 suggest that infants younger than 6 months should be kept away from direct sunlight exposure. 6,37 Traditional guidelines suggest that mothers with high amounts of vitamin D of 4,000-6,400 IU per day during pregnancy and lactation are required to increase both maternal and infant serum 25(OH)D concentrations to adequate levels [27][28][29] , however, recent studies have reported that infants of mothers supplemented with vitamin D >2,000 IU per day had similar serum 25(OH)D concentrations as infants receiving 400 IU per day [27][28][29] , and therefore, AAP 2008 6 and recently, the global consensus 2016 7 recommend that exclusively or partially breastfed infants should be given 400 IU vitamin D daily beginning within the first week of life regardless of being supplemented with formula, and this 400 IU vitamin D daily supplementation should be continued until the infant takes more than 1,000 mL per day of 400 IU vitamin D-fortified formula. 6,7 Also, the global consensus 2016 recommends that lactating women should take dietary vitamin D supplementation 600 IU per day for their own needs rather than a high daily dose of 4,000-6,400 IU vitamin D for the needs of both the mothers and their infants.…”