Exclusive breastfeeding during the first six months of life is universally recommended, but some critics of this practice claim that many breastfed children, especially in developing countries, suffer from vitamin D deficiency and even show signs and symptoms of rickets, a disorder related to the lack of vitamin D.
It has been estimated that breast milk does not contain the amount of vitamin D required for normal development, which means exclusively breastfed children are susceptible to vitamin D deficiency. In fact, some studies have shown that up to 70 percent of lactating women and their children have a vitamin D deficiency.
The Trial
A group of researchers from the University College of Medical Sciences and GTB Hospital in India, led by Dr. Prasanna Naik, conducted a study titled “Oral Supplementation of Parturient Mothers with Vitamin D and Its Effect on 25OHD Status of Exclusively Breastfed Infants at 6 Months of Age: A Double-Blind Randomized Placebo Controlled Trial,” in which a group of parturient mothers (less than forty-eight hours after giving birth) was given an oral daily dose of 60,000 IU of vitamin D3 for ten days. Another group of mothers was given a placebo.
All the women were encouraged to exclusively breastfeed their children and were trained by professional personnel for that purpose. Some of the mothers gave their babies occasional sips of water or juice but were still included in the study since it was assumed that such sips would not change the final results. None of the infants was excluded on account of mixed feeding. Sunlight exposure was also suggested and controlled.
The serum levels of 25OHD (a prehormone and a still nonactive form of vitamin D) were measured in both the mothers and their babies at the beginning of the study and at six months. Tests were also conducted to rule out any adverse effects related to vitamin D intake, and other tests looked for evidence of rickets.
The Results
The results of the study were overwhelming. Overall, maternal intake of vitamin D supplements during the first ten days after delivery increased serum levels of vitamin D in both the mother and the newborn. The increased levels of vitamin D prevented rickets in the children later in life.
At the start of the study, all the values measured in both groups were similar, but they changed radically in the subsequent analyses. The levels of 25OHD were much higher in the mothers and children in the supplementation group than in the placebo group.
No evidence of side effects due to vitamin D intake were found.
Perhaps the most interesting result was related to rickets. Although two children in each group showed radiological signs of the disease, no children in the vitamin D group showed any biochemical evidence of rickets. In contrast, ten infants in the placebo group exhibited biochemical signs of the disease.
Conclusion and Recommendations
In summary, vitamin D deficiency in mothers and its consequences for their children, including rickets, are prevalent in underdeveloped countries.
Although it was not possible to measure the levels of vitamin D in breast milk, the results are precise: supplementation raised the levels of vitamin D in the mother and the child. Moreover, the doses studied proved to be safe since there was no evidence of hypervitaminosis in any patient.
While these findings are significant, the results must be treated with caution because naive scientific or commercial interests may influence their interpretation.
The researchers recommend that mothers consume an oral dose of 60,000 IU of vitamin D for ten days as a daily supplement. Supplementation should start within twenty-four after delivery to raise the serum levels of 25OHD in their children, thereby preventing the development of biochemical rickets.
References
Naik, Prasanna, M. M. A. Faridi, Prerna Batra, and S. V. Madhu. “Oral Supplementation of Parturient Mothers with Vitamin D and Its Effect on 25OHD Status of Exclusively Breastfed Infants at 6 Months of Age: A Double-Blind Randomized Placebo-Controlled Trial.” Breastfeeding Medicine 12, no. 10 (2017): 621–628. Retrieved from http://online.liebertpub.com
Roth, Daniel E., Michael Leung, Elnathan Mesfin, Huma Qamar, Jessica Watterworth, and Eszter Papp. “Vitamin D Supplementation during Pregnancy: State of the Evidence from a Systematic Review of Randomised Trials.” BMJ 359 (2017): j5237. Retrieved from https://www.bmj.com/
