Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant
Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant
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DOI：
10.1093/ajcn/80.6.1752s
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发表时间：
2004-12-01
影响因子：
7.1
通讯作者：
Wagner, CL
中科院分区：
文献类型：
--
作者：
Hollis, BW;Wagner, CL
有关哺乳期补充维生素 D 的科学数据很少。哺乳期维生素 D 的每日推荐摄入量已任意设定为 400 IU/天（10 杯/天）。该建议与维持母亲和哺乳婴儿的维生素 D 营养状态无关，尤其是深色肤色的个体。我们的目的是研究高剂量孕妇维生素 D-2 补充剂对母亲和哺乳婴儿维生素 D 营养状况的影响。完全哺乳期妇女 (n = 18) 在出生后 1 个月加入 2 个治疗组中的 1 个，即 1600 IU 维生素 D-2 和 400 IU 维生素 D-3（产前维生素）或 3600 IU 维生素 D-2 和 400 IU 维生素 D-3，为期 3 个月的研究期。高剂量（1600 或 3600 IU/天）维生素 D-2 补充 3 个月可以安全地增加两组循环 25-羟基维生素 D [25(OH)D] 浓度。接受 2000 IU/天维生素 D 的母亲乳汁中的抗脊柱活性平均增加了 34.2 IU/L，而 4000 IU/天组的抗脊柱活性增加了 94.2 IU/L。哺乳婴儿循环 25(OH)D-2 浓度反映了母亲的摄入量和乳汁中的含量。由于阳光照射有限，每天摄入 400 IU 的维生素 D 无法维持循环中 25(OH)D 浓度，因此只能通过母乳向哺乳婴儿提供有限量的维生素 D。母亲每天摄入 2000 IU 维生素 D 会提高母亲和哺乳婴儿的循环 25(OH)D 浓度，尽管能力有限，特别是对于哺乳婴儿。母亲每天摄入 4000 IU 可以在改善母亲和新生儿维生素 D 营养状况方面取得实质性进展。
Scientific data pertaining to vitamin D supplementation during lactation are scarce. The daily recommended intake for vitamin D during lactation has been arbitrarily set at 400 IU/d (10 mug/d). This recommendation is irrelevant with respect to maintaining the nutritional vitamin D status of mothers and nursing infants, especially among darkly pigmented individuals. Our objective was to examine the effect of high-dose maternal vitamin D-2 supplementation on the nutritional vitamin D status of mothers and nursing infants. Fully lactating women (n = 18) were enrolled at 1 mo after birth to 1 of 2 treatment arms, ie, 1600 IU vitamin D-2 and 400 IU vitamin D-3 (prenatal vitamin) or 3600 IU vitamin D-2 and 400 IU vitamin D-3, for a 3-mo study period. High-dose (1600 or 3600 IU/d) vitamin D-2 supplementation for a period of 3 mo safely increased circulating 25-hydroxyvitamin D [25(OH)D] concentrations for both groups. The antirachitic activity of milk from mothers receiving 2000 IU/d vitamin D increased by 34.2 IU/L, on average, whereas the activity in the 4000 IU/d group increased by 94.2 IU/L. Nursing infant circulating 25(OH)D-2 concentrations reflected maternal intake and the amount contained in the milk. With limited sun exposure, an intake of 400 IU/d vitamin D would not sustain circulating 25(OH)D concentrations and thus would supply only limited amounts of vitamin D to nursing infants in breast milk. A maternal intake of 2000 IU/d vitamin D would elevate circulating 25(OH)D concentrations for both mothers and nursing infants, albeit with limited capacity, especially with respect to nursing infants. A maternal intake of 4000 IU/d could achieve substantial progress toward improving both maternal and neonatal nutritional vitamin D status.