TITLE:
Maternal Supplementation of Vitamin D During Lactation to Support Infant Vitamin D Needs: A Systematic Review
AUTHORS:
Kelly Schossow, Alena M. Clark, Mary A. Harris
KEYWORDS:
vitamin D, vitamin supplements, infant, breastfeeding, human milk
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.8 No.3,
September
11,
2018
ABSTRACT: Human
milk is generally considered to be insufficient in vitamin D. However, research
completed in the 1980s showed that the vitamin D content of human milk is
directly related to maternal serum vitamin D levels and therefore may
potentially be adequate if the mother’s vitamin D levels are sufficient. Approximately one-third of
the adult population, which includes breastfeeding women, in the United States
have vitamin D insufficiency or deficiency. Among infants, 90.4% of breastfed
infants are vitamin D deficient compared to 15.4% of formula fed infants. The
American Academy of Pediatrics (AAP) has therefore recommended all breastfed
infants be directly supplemented with 400 IU per day of vitamin D to decrease the risk of
vitamin D insufficiency and rickets. According to the AAP, compliance rates with
this recommendation ranges between 2% - 36%.
Because the recommendation to supplement may undermine breastfeeding, many
pediatricians do not inform their patients of the need to supplement.
Additionally, some parents are concerned about directly supplementing their
infant as risks may include allergic reactions to the ingredients, aspiration
pneumonia, accidental overdose, and changes in intestinal flora and pH which
may compromise the immune benefits of human milk. A literature review was
conducted to examine the effect of maternal supplementation with vitamin D
during lactation on human milk vitamin D content and maternal and infant serum
vitamin D levels. Although there is no current consensus regarding dosage and
timing of maternal vitamin D supplementation, the literature suggests that
high-dose vitamin D supplementation of the lactating mother is as effective at
maintaining infant vitamin D levels as direct infant supplementation, while
also correcting the mother’s vitamin D deficiency.