Written by Jessica Patella, ND. Participating mothers, who received 200,000 IU injections of Vitamin A just 24 hours postpartum, had a significant 134 % Vitamin A increase in colostrum and a 16.4 % decrease in Vitamin E. Researchers suggested that Vitamin E be added to the Vitamin A injections to compensate for this decrease.

women's health - pregnancy and lactationBoth vitamins A and E are fat soluble vitamins that are essential for growth, development, immunity and reproduction 1,2. Past animal studies have shown that supplementing with high doses of vitamin A reduced the serum levels of alpha-tocopherol (a form of vitamin E). A recent study in pregnant women found that supplementing with a high dose of vitamin A before birth resulted in lowered vitamin E levels in the colostrum (24 hours after birth) but had no change in mature milk (30 days after birth) 1.

Vitamin E deficiency is more common because of the rapid growth during the first few months of life and low reserves at birth, with an estimated 15% of newborns having vitamin E deficiency 1,3,4. Vitamin A deficiency affects approximately 19 million pregnant women in developing countries, of which 10 million have night blindness due to the deficiency 1,5. For this reason, many countries require an oral dose of 200,000 IU of vitamin A for pregnant women within 6 weeks of delivery to increase vitamin A in breast milk 1.

The research included 88 lactating mothers who were randomly placed in either a control group (n=44) or the vitamin A group (n=44). The vitamin A group received a single dose of 200,000 IU vitamin A (retinyl palmitate). Twenty-four hours after delivery, blood and colostrum samples were taken in both groups, then women in the supplement group were given 200,000 IU of vitamin A. Another sample of colostrum was taken 24 hours after the first collection. A final sample was collected 30 days after delivery 1.

At baseline, the blood levels of vitamin A and vitamin E did not differ between groups, with 5.7% of women deficient in vitamin A and 9.1% deficient in vitamin E 1.

Twenty-four hours after supplementation with vitamin A, the vitamin A (retinol) levels in colostrum increased by 131% (p<0.001), with no change in the control group. There was no difference in vitamin A levels in mature milk (30 days post-delivery) between the groups 1.

Twenty-four hours after supplementing with vitamin A, the colostrum levels of vitamin E (alpha-tocoptherol) decreased by 16.4% (P<0.05). However, there was no difference between the groups in the mature milk 1.

In conclusion, supplementing with high dose vitamin A immediately after birth significantly increased vitamin A levels in colostrum and decreased vitamin E levels in colostrum, but had no effect on mature milk 1. Researchers felt this was a matter of concern because breast milk is the only source of vitamin E in exclusively breastfed infants. However, there was no long term effect on vitamin E levels. The researchers suggested that vitamin E be included with the vitamin A supplementation, to help compensate for the reduced bioavailability of colostrum vitamin E 1.

Source: Grilo EC, et al. (2016) Maternal supplementation with a megadose of vitamin A reduces colostrum level of alpha-tocopherol: a randomized controlled trial. J Hum Nutr Diet 29, 652-661.

© 2016 The British Dietetic Association Ltd.

Posted October 13, 2016.

Jessica Patella, ND, is a naturopathic physician specializing in nutrition and homeopathic medicine and offers a holistic approach to health.  She earned her ND from Southwest College of Naturopathic Medicine in Tempe, AZ, and is a member of the North Carolina Association of Naturopathic Physicians. Visit her website at  ww.awarenesswellness.com.

References:

  1. Grilo EC, Medeiros WF, Silva AG, Gurgel CS, Ramalho HM, Dimenstein R. Maternal supplementation with a megadose of vitamin A reduces colostrum level of alpha-tocopherol: a randomised controlled trial. Journal of human nutrition and dietetics : the official journal of the British Dietetic Association. 2016;29(5):652-661.
  2. Debier C, Larondelle Y. Vitamins A and E: metabolism, roles and transfer to offspring. Br J Nutr. 2005;93(2):153-174.
  3. Traber MG. Vitamin E inadequacy in humans: causes and consequences. Advances in nutrition (Bethesda, Md). 2014;5(5):503-514.
  4. Kositamongkol S, Suthutvoravut U, Chongviriyaphan N, Feungpean B, Nuntnarumit P. Vitamin A and E status in very low birth weight infants. Journal of perinatology : official journal of the California Perinatal Association. 2011;31(7):471-476.
  5. Thorne-Lyman AL, Fawzi WW. Vitamin A and carotenoids during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis. Paediatr Perinat Epidemiol. 2012;26 Suppl 1:36-54.