Hollis Bruce W, Wagner Carol L, Howard Cynthia R, Ebeling Myla, Shary Judy R, Smith Pamela G, Taylor Sarah N, Morella Kristen, Lawrence Ruth A, Hulsey Thomas C
Division of Neonatology, Department of Pediatrics, Medical University of South Carolina Children's Hospital, Charleston, South Carolina;
Department of Pediatrics, University of Rochester, Rochester, New York; and.
Pediatrics. 2015 Oct;136(4):625-34. doi: 10.1542/peds.2015-1669.
Compare effectiveness of maternal vitamin D3 supplementation with 6400 IU per day alone to maternal and infant supplementation with 400 IU per day.
Exclusively lactating women living in Charleston, SC, or Rochester, NY, at 4 to 6 weeks postpartum were randomized to either 400, 2400, or 6400 IU vitamin D3/day for 6 months. Breastfeeding infants in 400 IU group received oral 400 IU vitamin D3/day; infants in 2400 and 6400 IU groups received 0 IU/day (placebo). Vitamin D deficiency was defined as 25-hydroxy-vitamin D (25(OH)D) <50 nmol/L. 2400 IU group ended in 2009 as greater infant deficiency occurred. Maternal serum vitamin D, 25(OH)D, calcium, and phosphorus concentrations and urinary calcium/creatinine ratios were measured at baseline then monthly, and infant blood parameters were measured at baseline and months 4 and 7.
Of the 334 mother-infant pairs in 400 IU and 6400 IU groups at enrollment, 216 (64.7%) were still breastfeeding at visit 1; 148 (44.3%) continued full breastfeeding to 4 months and 95 (28.4%) to 7 months. Vitamin D deficiency in breastfeeding infants was greatly affected by race. Compared with 400 IU vitamin D3 per day, 6400 IU/day safely and significantly increased maternal vitamin D and 25(OH)D from baseline (P < .0001). Compared with breastfeeding infant 25(OH)D in the 400 IU group receiving supplement, infants in the 6400 IU group whose mothers only received supplement did not differ.
Maternal vitamin D supplementation with 6400 IU/day safely supplies breast milk with adequate vitamin D to satisfy her nursing infant's requirement and offers an alternate strategy to direct infant supplementation.
比较母亲每日单独补充6400国际单位维生素D3与母亲和婴儿每日补充400国际单位维生素D3的效果。
产后4至6周居住在南卡罗来纳州查尔斯顿或纽约州罗切斯特的纯母乳喂养妇女被随机分为每日补充400、2400或6400国际单位维生素D3，为期6个月。400国际单位组的母乳喂养婴儿每日口服400国际单位维生素D3；2400和6400国际单位组的婴儿每日接受0国际单位（安慰剂）。维生素D缺乏定义为25-羟基维生素D（25(OH)D）<50 nmol/L。由于婴儿缺乏情况更严重，2400国际单位组于2009年结束。在基线时测量母亲血清维生素D、25(OH)D、钙和磷浓度以及尿钙/肌酐比值，之后每月测量一次，婴儿血液参数在基线以及第4和第7个月时测量。
在400国际单位和6400国际单位组入组的334对母婴中，216对（64.7%）在第1次访视时仍在母乳喂养；148对（44.3%）持续纯母乳喂养至4个月，95对（28.4%）至7个月。母乳喂养婴儿的维生素D缺乏受种族影响很大。与每日400国际单位维生素D3相比，每日6400国际单位安全且显著地使母亲的维生素D和25(OH)D较基线水平升高（P <.0001）。与400国际单位组接受补充剂的母乳喂养婴儿的25(OH)D相比，6400国际单位组中母亲仅接受补充剂的婴儿的25(OH)D没有差异。
母亲每日补充6400国际单位维生素D能安全地为母乳提供足够的维生素D以满足其哺乳婴儿的需求，并提供了一种替代直接给婴儿补充的策略。
