Assessment of the efficacy of 400 IU of oral Vitamin D3 supplementation for term healthy breastfed Indian infants

Abstract

itamin D has been traditionally known as an anti-rachitic factor or sunshine vitamin. In 1922, Edward Mellanby discovered Vitamin D while researching a disease called rickets. Besides its pivotal role in calcium homeostasis and bone mineral metabolism, Vitamin D in the endocrine system is now recognized to subserve a wide range of fundamental biological functions in cell differentiation, inhibition of cell growth, and immunomodulation [1][2][3]. Vitamin D modulates the transcription of cell cycle proteins, which decrease cell proliferation and increase cell differentiation of several specialized cells of the body, namely, osteoclastic precursors, enterocytes, and keratinocytes [4,5].Vitamin D status during pregnancy appears to play a role in fetal skeletal development, tooth enamel formation, and general fetal growth and development [6,7]. The Vitamin D stores of the newborn depend entirely on the Vitamin D stores of the mother. If the mother is Vitamin D deficient, the infant will be deficient because of decreased maternal-fetal transfer of Vitamin D. Resurgence of prolonged exclusive breastfeeding has led to a coincident increase in the incidence of Vitamin D deficiency in infancy. Worldwide public health authorities recommend exclusive breastfeeding for the first 6 months of life for all infants. However, breast milk does not generally supply the adequate amount of Vitamin D [8] due to which, breastfed infants are at risk of Vitamin D deficiency [9].Infants who are breastfed but do not receive supplemental Vitamin D or adequate sunlight exposure are at an increased risk of developing Vitamin D deficiency or rickets [10,11]. Human milk typically contains Vitamin D concentration of 25 IU/L or less [12]. Thus, the recommended adequate intake of Vitamin D cannot be met with human milk as the sole source of Vitamin D for the breastfeeding infant; although, there is evidence that ABSTRACT Introduction: Vitamin D is essential for growing children and its deficiency may have a catastrophic effect on growing children. Various reports state that Vitamin D deficiency is widely prevalent in the Indian population including infants and children. Objective: The objective of the study was to assess the efficacy of 400 IU of oral Vitamin D3 supplementation for term healthy breastfed Indian infants. Materials and Methods: The prospective, double-blinded cross-sectional study included 100 newborns divided into two randomized groups, A and B through a computer-generated program. Group A received 1 ml (400IU) Vitamin D drops daily for 3 months along with the breast milk whereas the Group B was only breastfed. Serum Vitamin D, Calcium, and alkaline phosphatase levels were measured in both the groups at birth and 3 months follow-up. Results: At birth no significant difference was observed in the serum level of Vitamin D, calcium and alkaline phosphatase in both the groups; however, at 3 month follow-up visit the Group A babies who were supplemented with Vitamin D 400 IU/day had a significantly more Vitamin D level (27.61 ± 11.95 ng/...