A nutritional supplement during preconception and pregnancy increases human milk vitamin D but not B-vitamin concentrations

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 42; no. 12; pp. 2443 - 2456
• Main Authors: Han, Soo Min, Huang, Fang, Derraik, José G B, Vickers, Mark H, Devaraj, Surabhi, Redeuil, Karine, Campos-Giménez, Esther, Pang, Wei Wei, Godfrey, Keith M, Chan, Shiao-Yng, Thakkar, Sagar K, Cutfield, Wayne S
• Format: Journal Article
• Language: English
• Published: England 01.12.2023
• Subjects: Cholecalciferol; Dietary Supplements; Double-Blind Method; Female; Humans; Infant; Lactation; Milk, Human - chemistry; Pregnancy; Vitamin A - analysis; Vitamin D - analysis; Vitamins - analysis; Human milk; Supplement; 25(OH)D3; Lactation; Vitamin D; Vitamin B
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2023.09.009

Optimal maternal vitamin status during pregnancy and lactation is essential to support maternal and infant health. For instance, vitamin D is involved in infant bone development, and B-vitamins are involved in various metabolic processes, including energy production. Through a double-blind randomised controlled trial, we investigated the effects of maternal supplementation from preconception throughout pregnancy until birth on human milk (HM) concentrations of vitamin D and B-vitamins. In addition, we aimed to characterise longitudinal changes in milk concentrations of these vitamins. Both control and intervention supplements contained calcium, iodine, iron, β-carotene, and folic acid, while the intervention also contained zinc, vitamins B , B , B , and D , probiotics, and myo-inositol. HM samples were collected across 4 time points from 1 week to 3 months post-delivery from 158 mothers in Singapore, and 7 time points from 1 week to 12 months from 180 mothers in New Zealand. HM vitamin D was quantified using supercritical fluid chromatography and B-vitamins with mass spectrometry. Potential intervention effects on HM vitamins D , B , B , and B , as well as other B-vitamin (B and B ) concentrations were assessed using linear mixed models with a repeated measures design. Over the first 3 months of lactation, HM 25-hydroxyvitamin D concentrations were 20% (95% CI 8%, 33%, P = 0.001) higher in the intervention group, with more marked effects in New Zealand. There were no observed intervention effects on HM concentrations of vitamins B , B , B , B , and B . In New Zealand mothers, longitudinally, vitamin D concentrations gradually increased from early lactation up to 12 months, while vitamins B and B peaked at 6 weeks, B at 3 weeks, and B and B at 3 months. Maternal supplementation during preconception and pregnancy increased HM vitamin D, but not B-vitamin concentrations in lactation. Further studies are required to examine the discrete benefits of vitamin D supplementation starting preconception vs during pregnancy, and to further characterise the effects of supplementation on later offspring health outcomes. Registered at ClinicalTrials.gov on the 16 July 2015 (identifier NCT02509988); Universal Trial Number U1111-1171-8056. This study was academic-led by the EpiGen Global Research Consortium.