Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial
Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial
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DOI：
10.1542/peds.2015-1669
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发表时间：
2015-10-01
期刊：
影响因子：
8
通讯作者：
Hulsey, Thomas C.
中科院分区：
文献类型：
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作者：
Hollis, Bruce W.;Wagner, Carol L.;Hulsey, Thomas C.
目的：比较产妇维生素D-3补充与6400国际单位，每天单独的产妇和婴儿补充与400国际单位，每天。方法：专门哺乳期妇女生活在查尔斯顿，南卡罗来纳州，或罗切斯特，纽约州，在产后4至6周被随机分配到400，2400，或6400国际单位的维生素D-3/天6个月。400 IU组的母乳喂养婴儿口服400 IU维生素D-3/天; 2400和6400 IU组的婴儿口服0 IU/天（安慰剂）。维生素D缺乏定义为25-羟基维生素D（25（OH）D），50 nmol/L。2009年，2400 IU组因婴儿缺乏症发生而终止。在基线时和每月测量母亲血清维生素D、25（OH）D、钙和磷浓度以及尿钙/肌酐比值，并在基线时和4个月和7个月时测量婴儿血液参数。（64.7%）在访视1时仍在母乳喂养; 148例（44.3%）继续完全母乳喂养至4个月，95例（28.4%）继续完全母乳喂养至7个月。母乳喂养婴儿的维生素D缺乏受种族的影响很大。与每天400 IU维生素D-3相比，6400 IU/天安全且显著地增加了母体维生素D和25（OH）D（P < .0001）。与母乳喂养的婴儿25（OH）D在400 IU组接受补充剂，婴儿在6400 IU组的母亲只收到supplement.CONCLUSIONS：产妇维生素D补充剂6400 IU/天安全地提供母乳与足够的维生素D，以满足她的哺乳婴儿的要求，并提供了一种替代策略，直接婴儿补充。
OBJECTIVE: Compare effectiveness of maternal vitamin D-3 supplementation with 6400 IU per day alone to maternal and infant supplementation with 400 IU per day.METHODS: Exclusively lactating women living in Charleston, SC, or Rochester, NY, at 4 to 6 weeks postpartum were randomized to either 400, 2400, or 6400 IU vitamin D-3/day for 6 months. Breastfeeding infants in 400 IU group received oral 400 IU vitamin D-3/day; infants in 2400 and 6400 IU groups received 0 IU/day (placebo). Vitamin D deficiency was defined as 25-hydroxy-vitamin D (25(OH) D),50 nmol/L. 2400 IU group ended in 2009 as greater infant deficiency occurred. Maternal serum vitamin D, 25(OH) D, calcium, and phosphorus concentrations and urinary calcium/creatinine ratios were measured at baseline then monthly, and infant blood parameters were measured at baseline and months 4 and 7.RESULTS: Of the 334 mother-infant pairs in 400 IU and 6400 IU groups at enrollment, 216 (64.7%) were still breastfeeding at visit 1; 148 (44.3%) continued full breastfeeding to 4 months and 95 (28.4%) to 7 months. Vitamin D deficiency in breastfeeding infants was greatly affected by race. Compared with 400 IU vitamin D-3 per day, 6400 IU/day safely and significantly increased maternal vitamin D and 25(OH) D from baseline (P < .0001). Compared with breastfeeding infant 25(OH) D in the 400 IU group receiving supplement, infants in the 6400 IU group whose mothers only received supplement did not differ.CONCLUSIONS: Maternal vitamin D supplementation with 6400 IU/day safely supplies breast milk with adequate vitamin D to satisfy her nursing infant's requirement and offers an alternate strategy to direct infant supplementation.