Professors Bruce Hollis, Carol Wagner and colleagues in South Carolina and New York have just published what should be the most influential vitamin D paper this year in the prestigious journal Pediatrics.
Hollis BW, Wagner CL, Howard CR, Ebeling M, Shary JR, Smith PG, Taylor SN, Morella K, Lawrence RA, Hulsey TC. Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial. Pediatrics. 2015 Oct;136(4):625-34.
This multicenter randomized controlled trial concluded that maternal vitamin D supplementation with 6400 IU/day safely provides the nursing infant with adequate amount of vitamin D. The amount currently recommended by the Institute of Medicine’s Food and Nutrition Board (400 IU/day) is basically irrelevant.
At the start of the study, the researchers prescribed 2,400 IU/d of vitamin D to a group of lactating mothers. However, so many infants in this group had 25(OH)D levels< 20 ng/ml, the ethics committee made them stop using this dose.
If mom takes 6,400 IU/day, the infants do not need to supplement with vitamin D as the American Academy of Pediatrics advises for breastfeeding infants. Giving 6,400 IU to breastfeeding moms has the same results on the infants 25(OH)D as when the infants take 400 IU/day. Remember, 400 IU/day for a ten-pound infant is equivalent by weight to me taking 8,000 IU/day. The main advantage of the moms taking it instead of just the infants is that both the infants and the moms reap the benefits from maintaining vitamin D sufficiency.
We actually knew all this from previous work by Dr. Hollis and Wagner. What was firmly laid out, in unambiguous language, is something I’ve written about for years. What is the best biomarker for vitamin D sufficiency? Is it PTH suppression; is it calcium absorption?
No, the best biomarker is measuring a breastfeeding mother’s 25(OH)D levels to determine how much daily vitamin D or sunshine it takes to turn human breast milk into an adequate source of vitamin D for the developing infant. If it takes 6,400 IU/day to do that, shouldn’t this dosage be utilized as the standard for maintaining vitamin D sufficiency in breastfeeding mothers and their infants? If that is the dose it takes to turn breast milk into an adequate source of vitamin D, shouldn’t we all be on similar doses?