Maintaining Vitamin E Concentrations in Breast Milk
Babies born prematurely are at greater ‘nutritional risk’ because many key nutrients – long-chain omega-3 fatty acid docosahexaenoic acid (DHA), vitamin D, and vitamin E - are passed from mother to infant in utero. Without the last trimester of pregnancy to acquire essential nutrients, preterm babies are at risk of being born with low body reserves.
Maternal vitamin E intake during pregnancy is associated with risk of birth defects in infants. Preterm infants are especially susceptible to vitamin E deficiency. When >90% of US women of child-bearing age are not consuming recommended amounts of vitamin E from food, they can have suboptimal vitamin E status. In a nationally representative survey of Irish adults, vitamin E supplements contributed approximately 30% of the vitamin E intake and supplement consumers had higher plasma α-tocopherol concentrations than non-consumers.
Medeiros and colleagues measured α-tocopherol concentrations in blood and breast milk in 89 lactating women. Maternal blood α-tocopherol concentrations averaged 27 µmol/L so none of the women were vitamin E deficient. Baseline α-tocopherol concentrations in breast milk were ~32 µmol/L. Breast milk vitamin E concentrations increased 60% and 35% 24h and 7d after a single dose of 400 IU vitamin E, respectively. Then, as expected, the vitamin E concentration in breast milk from supplemented women decreased to become similar to those in controls by 30d.
The authors clearly state the take home message for nursing mothers. “ In order to maintain adequate levels of vitamin E in mature breast milk, mothers should consume dietary vitamin E sources and/or vitamin E supplements. This is especially important for those who have had preterm births, as they are a risk group for nutritional deficiencies.”
A single dose, 400 IU, increases the α-tocopherol concentrations in breast milk but nursing mothers need to regularly consume vitamin E to maintain breast milk concentrations. The only alternative for nursing children would be to supplement their child with vitamin E.
Medeiros JFP, da Silva Ribeiro KD, Lima MSR, das Neves RAM, Lima ACP, Dantas RCS, da Silva AB, Dimenstein R. α-tocopherol in breast milk of women with preterm delivery after a single postpartum oral dose of vitamin E. 2016 Br J Nutr doi: 10.1017/S0007114516000477
Gilboa SM, Lee KA, Cogswell ME, Traven FK, Botto LD, Riehle-Colarusso T, Correa A, Boyle CA, the National Birth Defects Prevention Study. 2014 Clin Molecul Teratol doi: 10.1002/brda.23247
McBurney MI, Yu EA, Ciappio ED, Bird JK, Eggersdorfer M, Mehta S. Suboptimal sérum α-tocopherol concentrations observed among younger adults and those depending exclusively upon food sources, NHANES 2003-2006. 2015 PLoSONE doi: 10.1371/journal.pone.0135510
Zhao Y, Monahan FJ, McNulty BA, Gibney MJ, Gibney ER. Effect of vitamin E intake from food and supplement sources on plasma α- and γ-tocopherol concentrations in a healthy Irish adult population. 2014 Br J Nutr doi: 10.1017/S0007114514002438