Table 4 Summary effect of nutritional vitamins supplements on status of vitamin D human milk composition

Ala-Houhala [54]

Half of the mothers were supplemented daily throughout the study with one tablet containing 1000 IU (25 mg) of ergocalciferol. Throughout

20 mothers who delivered babies in the winter and from 20 mothers who delivered in the summer.

Randomized clinical trial

To investigate the possible effects of supplementing breast-feeding mothers with vitamin D and of the seasons on the concentrations of antirachitic sterols, ie, 25-hydroxyvitamin D (25- [OH]D) and vitamin D, in milk.

25 (OH) vitamin D

Supplementation had no effect on vitamin D levels. Milk 25-(OH) D levels of mothers receiving either 1000 or 2000 IU (25 or 50 g) vitamin D/d was significantly higher than those of un supplemented mothers in February and April.

1/5

Europe (EURO)

Basile [55]

Mothers were randomized to receive either 2000 or 4000 IU vitamin D supplementation per day. Groups 1 and 2 received 1600 and 3600 IU per day vitamin D2, respectively, in an oral suspension. Both groups received additional multivitamin capsules containing 400 IU vitamin D3 and were instructed to take them daily.

25 Lactating mothers (mean age: 30.6 ± 4.6)

Prospective, double-blinded, randomized

Controlled trial

To investigate breast milk [Ca] as a function of vitamin D supplementation regimen.

Circulating and Milk concentrations of vitamin D2, vitamin D3,

25(OH)D2, and 25(OH)D3

Mean maternal and infant total circulating 25(OH) D levels had statistically significant increases during the 3 months of high-dose vitamin D supplementation. Mothers in group 1 (who received 1600 IU/day vitamin D2 and 400 IU/day vitamin D3) exhibited increases in total circulating concentrations of 25(OH) D from baseline to 3 months (p ≤ 0.002).

4/5

Americas (AMRO)

Ketha [56]

Vitamin D3 as a single oral dose of 150,000 IU (N = 20), or 5000 IU daily (N = 20) for 28 days.

40 lactating females, ages 24–40 years, with a singleton infant between the ages of 1 and 6 months.

Randomized controlled trial

To investigate the effect of bolus versus daily vitamin D3 dosing regimens on temporal changes in 25(OH)D3/24,25(OH)2D3 ratio in a group of breast feeding mothers

Serum vitamin D3, 25(OH) D3, 24,25(OH)2D3, 1,25(OH)2D3, and breast milk vitamin D3.

Greater production of 24, 25(OH) 2D3 resulting from a single, high dose bolus of vitamin D than with a daily dose of vitamin D over the course of 28 days.

2/5

Americas (AMRO)

Niramitmahapanya [57]

One group received vitamin D3 1800 IU/d supplementation for 6 weeks, and members of the other group were given a placebo.

200 mothers at the third trimester (delivered singleton infants at term > 37 weeks).

Randomized double blinded control trial

To investigate whether vitamin D3 supplementation (1800

IU/day) can improve breastfed serum of infants and breast milk 25 (OH) D levels.

25 (oh) d

At 6 weeks, maternal 25 (OH) D levels had increased significantly in the vitamin D group (VD) 68.30 + 15.40 nmol/L compared to 55.15 + 13.57 nmol/L in the placebo group (p < 0.001).

4/5

South East Asia (SEARO)

Oberhelman [58]

Participants received oral cholecalciferol (vitamin D3) 5000 IU/d for 28 days or 150,000 IU once.

Forty mothers, mean age: 30.3 ± 2.9

Randomized clinical trial

To determine if a single monthly supplement was as effective as a daily maternal supplement in increasing breast milk vitamin D to achieve vitamin D sufficiency in their infants.

Cholecalciferol

In mothers given daily cholecalciferol, concentrations of serum and breast milk cholecalciferol attained steady levels of 18 and 8 ng/ ml, respectively from day 3 through 28. In mothers given the single dose, serum and breast milk cholecalciferol peaked at 160 and 40 ng/ml, respectively at day 1, before rapidly declining.

2/5

Americas (AMRO)

Wall [59]

A placebo group, a group who received one dosage of daily oral vitamin D3 (1000 IU), or a group who received 2 dosages of daily oral vitamin D3 (2000 IU)

48 pregnant mothers and their infants

A randomized, double blinded, Placebo-controlled trial

To examine the effect of vitamin D supplementation during pregnancy on breast-milk VDA in the first 2 mo of lactation.

Concentration Of vitamin d2, vitamin d3, 25(oh)d2, and 25(oh)d3 in Breast milk

Maternal vitamin D supplementation during pregnancy of 2000 IU/d (compared with 1000 IU/d and with a placebo) results in a higher VDA of breast milk ≥2 mo postpartum.

3/5

WPRO (Western Pacific Regional Office)