Single megadose vitamin A supplementation of Indian mothers and morbidity in breastfed young infants

Basu, Suman; Sengupta, Banani; Paladhi, P K Roy

doi:10.1136/pmj.79.933.397

Cited by 58 publications

(59 citation statements)

References 22 publications

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“…The magnitude of the effect of supplementation with either retinol or b-carotene on breast milk retinol concentrations has been highly variable as reported by nine randomized controlled trials in presumably HIV-uninfected women (Stoltzfus et al, 1993;Roy et 1999; Vinutha et al, 2000;Canfield et al, 2001;Muslimatun et al, 2001;Bahl et al, 2002;Basu et al, 2003;Dijkhuizen et al, 2004) and one randomized controlled trial in HIVinfected Malawian women (Semba et al, 2000). This variation likely depends on differences in the dose and timing of supplementation.…”

Section: Discussionmentioning

confidence: 99%

Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids and tocopherols in HIV-infected Tanzanian women

et al. 2007

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Background/Objective: The effect of daily prenatal and postnatal vitamin supplementation on concentrations of breast milk nutrients is not well characterized in HIV-infected women. We examined the impact of vitamin supplementation during pregnancy and lactation on breast milk concentrations of retinol, carotenoids and tocopherols during the first year postpartum among 626 HIV-infected Tanzanian women. Subjects/Methods: We conducted a randomized, double-blind, placebo-controlled trial. Women were assigned to one of four daily oral supplements: vitamin A þ b-carotene (VA þ BC); multivitamins (MV; B, C and E); MV þ VA þ BC or placebo. Concentrations of breast milk nutrients were determined by high-performance liquid chromatography at birth and every 3 months thereafter. Results: Supplementation with VA þ BC increased concentrations of retinol, b-carotene and a-carotene at delivery by 4799, 1791 and 84 nmol l À1 , respectively, compared to no VA þ BC (all Po0.0001). MV supplementation did not increase concentrations of a-tocopherol or d-tocopherol at delivery but significantly decreased concentrations of breast milk g-tocopherol and retinol. Although concentrations of all nutrients decreased significantly by 3 months postpartum, retinol, a-carotene and b-carotene concentrations were significantly higher among those receiving VA þ BC at 3, 6 and 12 months compared to no VA þ BC. a-Tocopherol was significantly higher, while g-tocopherol concentrations were significantly lower, among women receiving MV compared to no MV at 3, 6 and 12 months postpartum. Conclusions: Sustained supplementation of HIV-infected breastfeeding mothers with MV could be a safe and effective intervention to improve vitamin E concentrations in breast milk. VA þ BC supplementation increases concentrations of breast milk retinol but it is not recommended in HIV-infected mothers due to the elevated risk of vertical transmission.

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Section: Discussionmentioning

confidence: 99%

Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids and tocopherols in HIV-infected Tanzanian women

et al. 2007

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“…Stoltzfus et al (1993) observed higher serum retinol levels and fewer inadequate RDR in 6-month-old infants whose mothers had received 300 000 IU vitamin A 1-3 weeks after delivery compared with controls. In two Indian studies (Vinutha et al, 2000;Basu et al, 2003), significantly higher serum retinol levels were observed in 3-month-old infants whose mothers were supplemented with 200 000 IU vitamin A immediately after delivery compared with the placebo group. It is difficult to explain these differences in relation to our findings simply on the basis of socioeconomic conditions as all the cited studies were conducted on lowincome populations.…”

Section: Discussionmentioning

confidence: 99%

“…Maternal vitamin A supplementation has many advantages for the baby, as it provides adequate amounts of vitamin A on a daily basis through mother's milk, thus being considered the safest form of supplying this vitamin to newborn babies (Basu et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Impact of maternal vitamin A supplementation on the mother–infant pair in Brazil

et al. 2010

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Background/Objectives: Vitamin A deficiency (VAD) is a major public health problem. The supplementation of lactating women could be an effective strategy to combat it. The objective of this study was to assess the impact of maternal vitamin A supplementation on the mother-infant pair. Subjects/Methods: This was a double blind, placebo-controlled randomized clinical assay in which 33 women received 200 000 IU of vitamin A and 33 women received soy oil between 20th and 30th postpartum days. Maternal blood and milk samples were collected immediately before supplementation and 3 months after delivery, when blood was also collected from the babies. Retinol concentrations p0.70 mmol/l in serum and 1.05 mmol/l in milk were considered to indicate VAD. Results: Increase in serum retinol level was observed in the supplemented group compared with the pre-supplementation levels (1.05 and 1.17 mmol/l, respectively; P ¼ 0.026) and to the post-supplementation levels of the control group (1.02 mmol/l; P ¼ 0.032). Reduction in breast milk retinol was observed in the control group compared with the pre-supplementation levels (1.93 and 1.34 mmol/l, respectively; Po0.0001) and to the post-supplementation levels of the supplemented group (1.56 mmol/l; P ¼ 0.0003). There was significant difference in the prevalence of VAD in breast milk after supplementation, 55.6% (15/27) in the control group and 16.1% (5/31) in the supplemented group (P ¼ 0.002). VAD was present in 66.1% (39/59) of infants, with mean serum retinol levels of 0.64 ± 0.30 mmol/l in the control group and of 0.69 ± 0.26 mmol/l in the supplemented group. Conclusions: Supplementation had a positive impact on maternal vitamin A status. No effect on infant status was detectable 2 months after supplementation with a single dose.

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“…The foetus is totally dependent on the mother for the supply of nutrients essential to maintain its life. An optimal maternal nutritional status has been shown to reduce the risks of a preterm birth and low birth weight (1)(2)(3) , improve postnatal growth (4,5) , and reduce both maternal and infant morbidity and mortality (6)(7)(8)(9) . Despite a trend of improved infant growth in most countries due to enhanced intakes of macronutrients (10) , a low maternal nutritional status during the critical stage of foetal development subsequently contributes to growth retardation in the offspring and adverse health outcomes in later life (11) .…”

mentioning

confidence: 99%

Association of antioxidant vitamins and oxidative stress levels in pregnancy with infant growth during the first year of life

Hong

Park²,

Kim³

et al. 2008

Public Health Nutr.

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Objective: Whereas there are numerous reports in the literature relating the impact of maternal nutritional status on subsequent birth outcome, much less is known about the long-term impact on infant growth after birth. Therefore, we conducted a prospective cohort study to investigate the association of maternal micronutrient status (vitamins A, C and E, folate) and oxidative stress status in pregnancy with infant growth during the first year of life. Design: Prospective cohort study. Setting: Outpatient clinic of obstetrics, Ewha Womans University Hospital, Seoul, South Korea. Subjects and methods: Two groups were constructed for this study -the Ewha pregnancy cohort (n 5 677) and the infant growth cohort comprising follow-up live newborns of all the recruited pregnant women (n 5 317). Maternal serum vitamin and urinary oxidative stress levels were collected and infant weights and heights were measured at birth and at 6 and 12 months after birth. Results: Division of the subjects into folate-deficient and normal groups revealed that infant weight and height at 0, 6 and 12 months were adversely affected by folate deficiency. High maternal vitamin C was associated with increased infant weight and height at birth and after birth. Conclusion: Our findings indicate the importance of preventing folate deficiency and supplementing vitamin C during pregnancy.

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Single megadose vitamin A supplementation of Indian mothers and morbidity in breastfed young infants

Cited by 58 publications

References 22 publications

Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids and tocopherols in HIV-infected Tanzanian women

Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids and tocopherols in HIV-infected Tanzanian women

Impact of maternal vitamin A supplementation on the mother–infant pair in Brazil

Association of antioxidant vitamins and oxidative stress levels in pregnancy with infant growth during the first year of life

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