title: Effect of combined maternal and infant vitamin D supplementation on vitamin D status of exclusively breastfed infants.
abstract: Severe vitamin D deficiency in mothers and their breastfed infants is a significant health problem in the Middle East. Supplementation of the breastfed infant alone with the recommended dose of vitamin D may be insufficient in high-risk population. We investigated the effect of combined maternal and infant vitamin D supplementation on vitamin D status of the breastfed infant. We examined also the effect of supplementation on vitamin D antirachitic activity of breast milk in a subset of mothers. Healthy breastfeeding mothers (n = 90) were randomly assigned to 2000 IU daily (group 1) or 60,000 IU monthly (group 2) of vitamin D(2), and all their infants (n = 92) received 400 IU daily of vitamin D(2) for 3 months. Most infants had vitamin D deficiency - 25-hydroxyvitamin D [25(OH)D] <or= 37.5 nmol L(-1)- at study entry. Serum 25(OH)D concentrations at 3 months increased significantly from baseline in infants of mothers in group 1 (13.9 +/- 8.6 vs. 49.6 +/- 18.5 nmol L(-1), P < 0.0001) and group 2 (13.7 +/- 12.1 vs. 44.6 +/- 15.0 nmol L(-1), P < 0.0001). Maternal and infant serum 25(OH)D concentrations correlated positively at baseline (r = 0.36, P = 0.01) and 3 months (r = 0.46, P = 0.002). Milk antirachitic activity increased from undetectable (<20 IU L(-1)) to a median of 50.9 IU L(-1). In conclusion, combined maternal and infant vitamin D supplementation was associated with a threefold increase in infants' serum 25(OH)D concentrations and a 64% reduction in the prevalence of vitamin D deficiency without causing hypervitaminosis D.
authors.affiliation: Department of Internal Medicine, United Arab Emirates University, Al Ain, United Arab Emirates. saadih@uaeu.ac.ae
authors.forename: Hussein F
authors.initials: HF
authors.lastname: Saadi
authors.forename: Adekunle
authors.initials: A
authors.lastname: Dawodu
authors.forename: Bachar
authors.initials: B
authors.lastname: Afandi
authors.forename: Reem
authors.initials: R
authors.lastname: Zayed
authors.forename: Sheela
authors.initials: S
authors.lastname: Benedict
authors.forename: Nicolaas
authors.initials: N
authors.lastname: Nagelkerke
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Hollis
mesh_terms: D000328:Adult; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology; D007231:Infant, Newborn; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena / Q000502:physiology; D008895:Milk, Human / Q000737:chemistry* / Q000378:metabolism; D009752:Nutritional Status; D013472:Sunlight; D014479:United Arab Emirates / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood* / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D