Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Nutrients. 2021 Jul 10;13(7):2370. doi: 10.3390/nu13072370.
The nutritional status of vitamin A in lactating mothers and infants is still not optimistic. Due to the dietary habits and dietary restrictions of postpartum customs in China, vitamin A supplementation has been advocated as a potential strategy to improve vitamin A status of lactating mothers with inadequate dietary vitamin A intake. Existing clinical trials are limited to single or double high-dose maternal administrations. However, in China, vitamin A supplements are readily available in the form of daily oral low-dose supplements, and the effect of these is unknown. This study aimed to evaluate the effects of daily oral low-dose vitamin A supplementation on the retinol levels in the serum and breast milk of lactating mothers and the health status of infants in China.
Lactating mothers who met the inclusion criteria and planned to continue exclusive breastfeeding were randomly assigned to receive either daily oral vitamin A and D drops (one soft capsule of 1800 IU vitamin A and 600 IU vitamin D), or a matching placebo for 2 months. Before and after the intervention, dietary intake was investigated by instant photography, and the retinol concentration in maternal serum and breast milk was determined by ultra-high performance liquid chromatography-tandem mass spectrometry. During the trial, the health status of infants was diagnosed by a paediatrician or reported by lactating mothers. A total of 245 participants completed the study, with 117 in the supplementation group and 128 in the control group.
After the 2-month intervention, maternal serum retinol concentrations increased in the supplementation group with no change in the control group. Although breast milk retinol concentrations decreased significantly in both groups, the decrease in the supplementation group was significantly lower than that in the control group. However, maternal vitamin A supplementation was not associated with a lower risk of infant febrile illness, respiratory tract infection, diarrhoea, and eczema.
Daily oral low-dose vitamin A supplementation is helpful in improving maternal vitamin A status, despite having no effect on infant health status through breast milk.
哺乳期母婴维生素 A 营养状况仍不容乐观。由于中国产后习俗的饮食习惯和饮食限制，维生素 A 补充剂已被提倡作为改善维生素 A 摄入不足的哺乳期母亲维生素 A 状况的潜在策略。现有的临床试验仅限于单次或双次高剂量的母亲给药。然而，在中国，维生素 A 补充剂以每日口服低剂量补充剂的形式很容易获得，其效果尚不清楚。本研究旨在评估每日口服低剂量维生素 A 补充剂对中国哺乳期母亲血清和母乳中视黄醇水平以及婴儿健康状况的影响。
符合纳入标准并计划继续纯母乳喂养的哺乳期母亲被随机分配接受每日口服维生素 A 和 D 滴剂（一粒 1800IU 维生素 A 和 600IU 维生素 D 的软胶囊）或匹配的安慰剂，持续 2 个月。在干预前后，通过即时摄影调查膳食摄入情况，并通过超高效液相色谱-串联质谱法测定母体血清和母乳中的视黄醇浓度。在试验过程中，由儿科医生诊断或由哺乳期母亲报告婴儿的健康状况。共有 245 名参与者完成了研究，其中补充组 117 名，对照组 128 名。
在 2 个月的干预后，补充组的母体血清视黄醇浓度增加，而对照组没有变化。尽管两组母乳视黄醇浓度均显著下降，但补充组的下降幅度明显低于对照组。然而，母体维生素 A 补充与婴儿发热疾病、呼吸道感染、腹泻和湿疹的风险降低无关。
尽管通过母乳，每日口服低剂量维生素 A 补充对婴儿健康状况没有影响，但有助于改善母亲的维生素 A 状况。
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