Infant’s Vitamin D Status Depends upon Mom
One of the most exciting moments, and frightening (at least the first time), is learning you are about to become a parent. The period from conception to 2 years of age is known as the “first 1,000 days of life”. Mounting evidence suggests a child’s life is profoundly affected by experiences during this 1,000 days.
5,592 scientific studies examining childhood obesity risk factors during the first 1,000 days were reviewed. With a disappointing <5% meeting their inclusion criteria, Woo Baidal and colleagues found higher maternal pre-pregnancy BMI, prenatal tobacco exposure, maternal excess gestational weight gain, high infant birth weight, and accelerated infant weight gain were associated with later childhood obesity. An infant cannot change their circumstances. What should parents and caregivers know?
Almost half of all deaths among children under five are attributable to undernutrition. A child’s wellbeing is directly determined by dietary intake (energy, protein, fat, and micronutrients) and health status. Underlying determinants of the child’s nutritional status are secure access to food of adequate quality (food security), quality of caring practices for children and women (child feeding, health-seeking behaviors, and cognitive stimulation), access to safe water, sanitary facilities for disposing of human waste, health services, and shelter.
Nutrients, such as vitamin D, iron, zinc, and docosahexaenoic acid (DHA), are critically important for developing young children. Meeting nutritional requirements of pregnant and lactating women and their nursing infants is fundamentally important.
Infants are solely dependent upon their caregivers. Vitamin D is essential to build strong bones and developing teeth. The vitamin D content of human milk depends upon the vitamin status of the nursing woman. Because the vitamin D content of human milk is often low, the North American recommendation has been routine vitamin D supplementation for breast-fed infants.
Either approach, supplementing nursing women or supplementing exclusively breastfed/fully breastfed infants, will increase 25(OH)D3 concentrations in the infant. The choice is the mother’s.
A nursing mother can choose to increase her own vitamin D status or she can supplement her infant. The infant has only one option – obtaining vitamin D from breast milk or direct administration of vitamin D. There is only one outcome, measured by the infant’s 25(OH)D status. Higher vitamin D status from infancy to 3y of age is associated with leaner body composition.
Nutrition during the first 1,000 days matters.
Woo Baidal JA, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, Taveras EM. Risk factors for childhood obesity in the first 1,000 days. 2016 Am J Prev Med doi: 10.1016/j.amepre.2015.11.012
Smith LC, Haddad L. Reducing child undernutrition: Past drivers and priorities for the post-MDG era. 2015 World Develop doi: 10.1016/j.worlddev.2014.11.014
Maffeis C. Overweight and obesity: prevention in the first 1,000 days of life. 2015 Ital J Pediatr doi: 10.1186/1924-7288-41-S2-A44
Hazell TJ, Gallo S, Vanstone CA, Agellon S, Rodd C, Weiler HA. Vitamin D supplementation trial in infancy: body composition effects at 3 years of age in a prospective follow-up study from Montreal. 2016 Pediatricobesity doi: 10.1111/ijpo.12105
Roth DE. Maternal postpartum high-dose vitamin D3 supplementation (6,400 IU/day) or conventional infant vitamin D3 supplementation (400 IU/day) lead to similar vitamin D status of healthy exclusively/fully breastfeeding infants by 7 months of age. 2015 Evid Based Med doi: 10.1136/ebmed-2015-110354