title: Maternal supplementation with a megadose of vitamin A reduces colostrum level of α-tocopherol: a randomised controlled trial.
abstract: Maternal supplementation with vitamin A is one of the strategies for controlling its deficiency in the mother-child dyad, although studies with animals showed that supplementation with high doses of vitamin A reduces the levels of α-tocopherol (vitamin E) in the mother's serum and milk. The objective of the present study was to assess the influence of maternal supplementation with vitamin A on the concentration of retinol and α-tocopherol in human milk.
  
  
  
  Healthy puerperal women were randomly distributed into a control group (n = 44) and a supplemented group (n = 44). Blood and colostrum samples were collected after delivery, and mature milk samples were collected 30 days later. The supplemented group received 200 000 IU of retinyl palmitate after the first colostrum collection. The retinol and α-tocopherol levels in the samples were determined by high-performance liquid chromatography.
  
  
  
  The mean (SD) retinol and α-tocopherol levels in the maternal serum were considered adequate at 46.4 (15.9) and 1023.6 (380.4) μg dL(-1) , respectively. The colostrum retinol levels of the supplemented group increased significantly 24 h after the intervention (P < 0.001). However, the retinol levels in the mature milk of both groups did not differ (P > 0.05). Moreover, after maternal supplementation with vitamin A, the colostrum α-tocopherol level decreased by 16.4%, which is a significant reduction (P < 0.05). However, vitamin A supplementation did not affect the α-tocopherol level of mature milk (P > 0.05).
  
  
  
  Maternal supplementation with high doses of vitamin A increased the colostrum level of this nutrient but reduced the bioavailability of α-tocopherol, which may harm the newborn's health because newborns have limited vitamin E reserves.
authors.affiliation: Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil. evellyn-cg@hotmail.com.
authors.forename: E C
authors.initials: EC
authors.lastname: Grilo
authors.affiliation: Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil.
authors.forename: W F
authors.initials: WF
authors.lastname: Medeiros
authors.affiliation: Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil.
authors.forename: A G A
authors.initials: AG
authors.lastname: Silva
authors.affiliation: Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil.
authors.forename: C S S
authors.initials: CS
authors.lastname: Gurgel
authors.affiliation: Department of Biotechnology, School of Health, Potiguar University (UnP), Laurate International Universities, Natal, Brazil.
authors.forename: H M M
authors.initials: HM
authors.lastname: Ramalho
authors.affiliation: Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Dimenstein
mesh_terms: D001938:Brazil / Q000453:epidemiology; D003126:Colostrum / Q000378:metabolism*; D003906:Developing Countries; D019587:Dietary Supplements / Q000009:adverse effects*; D004224:Diterpenes; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation / Q000097:blood / Q000378:metabolism*; D059012:Lost to Follow-Up; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D008895:Milk, Human / Q000378:metabolism; D009752:Nutritional Status; D049590:Postpartum Period; D000084562:Retinyl Esters; D012306:Risk; D014801:Vitamin A / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism / Q000633:toxicity; D014802:Vitamin A Deficiency / Q000097:blood / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control; D014811:Vitamin E Deficiency / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D024502:alpha-Tocopherol / Q000037:antagonists & inhibitors* / Q000097:blood / Q000378:metabolism
chemical_list: D004224:Diterpenes; D000084562:Retinyl Esters; D014801:Vitamin A; C014794:retinol palmitate; D024502:alpha-Tocopherol
keywords: dietary supplementation; human milk; serum; vitamin A; vitamin E