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

• Published in: The American journal of clinical nutrition 2015-08, Vol.102 (2), p.402-410
• Main Authors: March, Kaitlin M, Chen, Nancy N, Karakochuk, Crystal D, Shand, Antonia W, Innis, Sheila M, von Dadelszen, Peter, Barr, Susan I, Lyon, Michael R, Whiting, Susan J, Weiler, Hope A, Green, Tim J
• Format: Article
• Language: English
• Subjects: 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
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.114.106385

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. 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. 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. 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 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). Maternal supplementation beginning in gestation with 50 μg vitamin D₃/d protects 98% of unsupplemented breastfed infants against 25(OH)D deficiency (