Effect of vitamin D supplementation, directly or via breast milk for term infants, on serum 25 hydroxyvitamin D and related biochemistry, and propensity to infection: a randomised placebo-controlled trial

• Published in: British journal of nutrition Vol. 116; no. 1; pp. 52 - 58
• Main Authors: Chandy, David D., Kare, Jahnavi, Singh, Shakal N., Agarwal, Anjoo, Das, Vinita, Singh, Urmila, Ramesh, V., Bhatia, Vijayalakshmi
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 14.07.2016
• Subjects: Biochemistry; Breast milk; Breastfeeding & lactation; Cholecalciferol - administration & dosage; Cholecalciferol - metabolism; Cholecalciferol - pharmacology; Dietary Supplements; Female; Hormones; Humans; Infant; Infant Formula; Infant Nutritional Physiological Phenomena - physiology; Infant, Newborn; Infants; Infection - etiology; Lactation - metabolism; Male; Maternal Nutritional Physiological Phenomena - physiology; Milk, Human; Nutritional Endocrinology; Risk Factors; Sun; Sunlight; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Infants; Sunshine; Vitamin D; Lactation; IQR interquartile range; PTH parathyroid hormone; 25(OH)D 25-hydroxyvitamin D
• ISSN: 0007-1145; 1475-2662
• DOI: 10.1017/S0007114516001756

We assessed the effect of vitamin D supplementation on related biochemistry, infection and dentition of the infant. In a double-blind, placebo-controlled trial conducted in Lucknow, India (latitude 26°N), 230 mother –newborn pairs were randomised to receive, for 9 months, 3000µg/month oral vitamin D3 by the mother (group A) or 10µg/d by the infant (group B) or double placebo (group C). All babies received 15 min of sun exposure (unclothed) during massage. Infants’ median 25-hydroxyvitamin D (25(OH)D) was lower in group C (median 45·3; interquartile range (IQR) 22–59·5 nmol/l) than in groups A (median 60·8; IQR 41·3–80·5 nmol/l (P<0·01)) and B (median 61·3; IQR 41·3–75·3 nmol/l (P<0·05)) at 3·5 months. Infant 25(OH)D correlated negatively with infant parathyroid hormone (r −0·46, P<0·01). Elevated alkaline phosphatase (>7.5µkat/l) was significantly more frequent in group C babies (16 %) than in group A (4 %) or group B (0 %) babies. The number of days with respiratory or diarrhoeal infection by 9 months of age was higher in group C (median 46·5; IQR 14·8–73·3 d) than in group A (median 18·5; IQR 8·8–31·0 d (P<0·01)) or group B (median 13·0; IQR 7·0–28·5 (P<0·05)). We conclude that monthly maternal or daily infant supplementation with vitamin D along with sun exposure is superior to sun exposure alone in maintaining normal infant 25(OH)D at 3·5 months, and provide protection from elevated alkaline phosphatase and infectious morbidity.