Maternal and infant vitamin D status during lactation: Is latitude important? ()
Background: The effect of latitude on maternal and infant vitamin D status during lactation is presumed to be strongly associated with higher rates of deficiency in those living at higher latitudes, yet with lifestyle changes, this conclusion may no longer be correct. Objective: To ascertain if higher latitude adversely affects the vitamin D status of lactating women and their fully breastfeeding infants. Study Design/Methods: Fully breastfeeding women and their infants were eligible for participation in this study as part of a larger prospective vitamin D supplementation trial. Women were recruited from two sites of differing latitude: Charleston, SC at 32°N and Rochester, NY at latitude 43°N. Maternal and infant baseline vitamin D status, intact parathyroid hormone (IPTH), serum calcium and phosphorus as a function of site/latitude were measured. The primary outcome was maternal and infant total circulating 25(OH)D at baseline by center/latitude, and the secondary outcome was the percent of women and infants who had achieved a baseline concentration of at least 20 ng/mL, meeting the Institute of Medicine’s definition of sufficiency at 4 to 6 weeks postpartum. Statistical analysis was performed using SAS version 9.3. Results: Higher latitude adversely affected vitamin D status only in lactating Caucasian women. African American and Hispanic women and infants living in Rochester compared to Charleston had improved vitamin D status, an effect that was no longer significant when controlling for socioeconomic factors and season. Overall, there was a significant vitamin D deficiency at baseline in lactating mothers, and a far greater deficiency in their infants. Maternal baseline 25(OH)D concentration remained positively associated with being Caucasian, BMI and summer months. Breastfeeding infant vitamin D status mirrored maternal status and remained positively associated with being Caucasian and summer months. Those infants who had been on a vitamin D supplement at the time of enrollment in the study had markedly improved vitamin D status compared to those infants not on supplement, but represented a significant minority of the cohort. Conclusions: There was a significant vitamin D deficiency among a cohort of women and their infants living at two diverse latitudes—Charleston, SC and Rochester, NY. Given the higher rate of vitamin D deficiency among African American and Hispanic women and their infants living at a lower latitude, conclusions about vitamin D status based on latitude alone may be faulty.
Cite this paper
Conflicts of Interest
The authors declare no conflicts of interest.
Ladizesky, M., Lu, Z., Oliveri, B., San Roman, N., Diaz, S., Holick, M.F., et al. (1995) Solar ultraviolet B radiation and photoproduction of vitamin D3 in central and southern areas of Argentina. Journal of bone and mineral research: The Official Journal of the American Society for Bone and Mineral Research, 10, 545-549.
Holick, M.F. (1981) The cutaneous photosynthesis of previtamin D3: A unique photoendocrine system. Journal of Investigative Dermatology, 77, 51-58.
Webb, A.R., Kline, L. and Holick, M.F. (1988) Influence of season and latitude on the cutaneous synthesis of vitamin D3 synthesis in human skin. The Journal of Clinical Endocrinology & Metabolism, 67, 373-378.
Oliveri, M.B., Ladizesky, M., Mautalen, C.A., Alonso, A. and Martinez, L. (1993) Seasonal variations of 25 hydroxyvitamin D and parathyroid hormone in Ushuaia (Argentina), the southernmost city of the world. Bone Miner, 20, 99-108.
Porojnicu, A.C., Lagunova, Z., Robsahm, T.E., Berg, J.P., Dahlback, A. and Moan, J. (2007) Changes in risk of death from breast cancer with season and latitude: Sun exposure and breast cancer survival in Norway. Breast Cancer Research and Treatment, 102, 323-328.
Basile, L.A., Taylor, S.N., Wagner, C.L., Quinones, L. and Hollis, B.W. (2007) Neonatal vitamin D status at birth at latitude 32 degrees 72': Evidence of deficiency. Journal of Perinatology, 27, 568-571.
|||Hamilton, S.A., McNeil, R., Hollis, B.W., Davis, D.J., Winkler, J., Cook, C., et al. (2010) Profound vitamin D deficiency in a diverse group of women during pregnancy living in a sun-rich environment at latitude 32 degrees N. International Journal of Endocrinology, 917428.|
Johnson, D.D., Wagner, C.L., Hulsey, T.C., McNeil, R.B., Ebeling, M. and Hollis, B.W. (2010) Vitamin D deficiency and insufficiency is common during pregnancy. American Journal of Perinatology, 28, 7-12.
Wagner, C.L. and Greer, F.R. (2008) Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics, 122, 1142-1152.
|||Wagner, C.L., Hulsey, T.C., Fanning, D., Ebeling, M. and Hollis, B.W. (2006) High-dose vitamin D3 supplementation in a cohort of breastfeeding mothers and their infants: A 6-month follow-up pilot study. Breastfeed Medicine, 1, 59-70. http://dx.doi.org/10.1089/bfm.2006.1.59|
|||Hollis, B.W. and Wagner, C.L. (2004) Assessment of dietary vitamin D requirements during pregnancy and lactation. The American Journal of Clinical Nutrition, 79, 717 -726.|
Hollis, B.W. and Wagner, C.L. (2011) The vitamin D requirement during human lactation: The facts and IOM’s “utter” failure. Public Health Nutrition, 14, 748-749.
Hollis, B.W., Johnson, D., Hulsey, T.C., Ebeling, M. and Wagner, C.L. (2011) Vitamin D supplementation during pregnancy: Double-blind, randomized clinical trial of safety and effectiveness. Journal of Bone and Mineral Research: The Official Journal of the American Society for Bone and Mineral Research, 26, 2341-2357.
Greer, F.R., Hollis, B.W., Cripps, D.J. and Tsang, R.C. (1984) Effects of maternal ultraviolet B irradiation on vitamin D content of human milk. Journal of Pediatrics, 105, 431-433.
Greer, F.R., Hollis, B.W. and Napoli, J.L. (1984) High concentrations of vitamin D2 in human milk associated with pharmacologic doses of vitamin D2. Journal of Pediatrics, 105, 61-64.
|||Hollis, B. and Wagner, C. (2004) Vitamin D requirements during lactation: High-dose maternal supplementation as therapy to prevent hypovitaminosis D in both mother and nursing infant. The American Journal of Clinical Nutrition, S80, 1752-1758.|
|||Gartner, L. and Greer, F. (2003) American academy of pediatrics. Section on breastfeeding medicine and committee on nutrition. Prevention of rickets and vitamin D deficiency: New guidelines for vitamin D intake. Pediatrics, 111, 908-910. http://dx.doi.org/10.1542/peds.111.4.908|
|||Labbok, M.H. and Krasovec, K. (1990) Toward consistency in breastfeeding definitions. Studies in Family Planning, 21, 226-230. http://dx.doi.org/10.2307/1966617|
Coffin, C.F., Labbok, M.H. and Belsey, M. (1997) Breastfeeding definitions. Contraception, 55, 323-325.
|||Hollis, B.W., Kamerud, J.Q., Selvaag, S.R. and Lorenz, J.D. (1993) Determination of vitamin D status by radioimmunoassay with a 125I-labeled tracer. Clinical Chemistry, 39, 529-533.|
|||Laboratories, M.C. (2004) Laboratory reference data. Mayo Clinic, Rochester.|
Hollis, B.W. and Wagner, C.L. (2005) Normal serum vitamin D levels. The New England Journal of Medicine, 352, 515-516.
|||Hollis, B. (2005) Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: Implications for establishing a new effective dietary intake recommendation for vitamin D. The Journal of Nutrition, 135, 317-322.|
|||Vieth, R., Ladak, Y. and Walfish, P. (2003) Age-related changes in the 25-hydroxyvitamin D versus parathyroid hormone relationship suggest a different reason why older adults require more vitamin D. The Journal of Clinical Endocrinology & Metabolism, 88, 185-191.|
|||Food and Nutrition Board (2010) Standing Committee on the scientific evaluation of dietary reference intakes. Dietary reference intakes for vitamin D and calcium. National Academy Press, Washington DC.|
Shaikh, U. and Alpert, P. (2004) Practices of vitamin D recommendation in Las Vegas, Nevada. Journal of Medical Microbiology, 20, 56-61.
Copyright © 2020 by authors and Scientific Research Publishing Inc.
This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.