Maternal vitamin D₃ supplementation at 50 μg/d protects against low serum 25-hydroxyvitamin D in infants at 8 wk of age: a randomized controlled trial of 3 doses of vitamin D beginning in gestation and continued in lactation

Am J Clin Nutr. 2015 Aug;102(2):402-10. doi: 10.3945/ajcn.114.106385. Epub 2015 Jul 8.

Abstract

Background: Vitamin D supplementation is recommended for breastfed infants. Maternal supplementation beginning in gestation is a potential alternative, but its efficacy in maintaining infant 25-hydroxyvitamin D [25(OH)D] concentration after birth is unknown.

Objectives: We determined the effect of 3 doses of maternal vitamin D supplementation beginning in gestation and continued in lactation on infant serum 25(OH)D and compared the prevalence of infant serum 25(OH)D cutoffs (>30, >40, >50, and >75 nmol/L) by dose at 8 wk of age.

Design: Pregnant women (n = 226) were randomly allocated to receive 10, 25, or 50 μg vitamin D₃/d from 13 to 24 wk of gestation until 8 wk postpartum, with no infant supplementation. Mother and infant blood was collected at 8 wk postpartum.

Results: At 8 wk postpartum, mean [nmol/L (95% CI)] infant 25(OH)D at 8 wk was higher in the 50-μg/d [75 (67, 83)] than in the 25-μg/d [52 (45, 58)] or 10-μg/d [45 (38, 52)] vitamin D groups (P < 0.05). Fewer infants born to mothers in the 50-μg/d group had a 25(OH)D concentration <30 nmol/L (indicative of deficiency) than infants in the 25- and 10-μg/d groups, respectively (2% compared with 16% and 43%; P < 0.05). Fewer than 15% of infants in the 10- or 25-μg/d groups achieved a 25(OH)D concentration >75 nmol/L compared with 44% in the 50-μg/d group (P < 0.05). Almost all infants (∼98%, n = 44) born to mothers in the 50-μg/d group achieved a 25(OH)D concentration >30 nmol/L. At 8 wk postpartum, mean maternal 25(OH)D concentration was higher in the 50-μg/d [88 (84, 91)] than in the 25-μg/d [78 (74, 81)] or 10-μg/d [69 (66, 73)] groups (P < 0.05).

Conclusions: Maternal supplementation beginning in gestation with 50 μg vitamin D₃/d protects 98% of unsupplemented breastfed infants against 25(OH)D deficiency (<30 nmol/L) to at least 8 wk, whereas 10 or 25 μg vitamin D/d protects only 57% and 84% of infants, respectively.

Trial registration: ClinicalTrials.gov NCT01112891.

Keywords: 25(OH)D; infant; lactation; postpartum; pregnancy; supplement; vitamin D.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • British Columbia / epidemiology
  • Calcifediol / blood*
  • Calcifediol / metabolism
  • Calcium / blood
  • Child Development
  • Cholecalciferol / administration & dosage*
  • Cholecalciferol / adverse effects
  • Cholecalciferol / deficiency
  • Cholecalciferol / therapeutic use
  • Dietary Supplements* / adverse effects
  • Double-Blind Method
  • Female
  • Fetal Blood / chemistry
  • Humans
  • Hypercalcemia / blood
  • Hypercalcemia / epidemiology
  • Hypercalcemia / etiology
  • Infant, Newborn
  • Intention to Treat Analysis
  • Lactation* / metabolism
  • Male
  • Maternal Nutritional Physiological Phenomena*
  • Patient Compliance
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / etiology
  • Prevalence
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / congenital
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / prevention & control*

Substances

  • Cholecalciferol
  • Calcifediol
  • Calcium

Associated data

  • ClinicalTrials.gov/NCT01112891