392 - Differences in Bone Mineral Content and Bone Mineral Density of Infants Receiving Direct vs. Indirect Vitamin D Supplementation: A Randomized Controlled Lactation Study
n/a n/a Medical University of South Carolina Charleston, South Carolina, United States
Background: Vitamin D (vitD) plays a significant role in the maintenance of bone mineral homeostasis. It is unknown if a difference in bone mineral content (BMC) and bone mineral density (BMD) exists between infants who receive direct vitD supplementation and those who receive vitD indirectly via their mother’s breastmilk, while she received a high dose of vitD. It is hypothesized that there would be no differences in BMC or BMD based on treatment group.
Objective:
Design/Methods: Randomized, double-blind trial to compare BMC and BMD of infants who received direct vitD supplementation (400 IU vitD3/day) in addition to their mother receiving standard dosage (400 IU vitD3/day), versus infants whose mothers were their only source of vitD and were given high dose supplementation (2400 or 6400 IU vitD3/day). Participants were exclusively breastfeeding mothers and their singleton infant consuming only human milk. Infant BMC and BMD were measured by DXA scans of the infant’s total body (Hologic Discovery A Densitometer and Infant software) at 1-, 4-, and 7- months of age. Data were analyzed by t-test and mixed regression models using SAS 9.4.
Results: Infant BMC and BMD did not differ significantly at 1-, 4-, or 7 months between direct and indirect supplementation arms. See figures 1 and 2. The mean difference in BMC from 1-7 months was 1.624 g and 1.464 g for the 400 IU and 6400 IU groups, respectively (p=0.5); the mean difference in BMD over this same period was 0.042 g/cm2and 0.032 g/cm2 for the 400 IU and 6400 IU groups, respectively (p=0.2). See table 1. Although some differences among races were observed, they did not reflect changes in bone growth between the treatment arms. Conclusion(s): As evidenced by similar infant BMC and BMD between treatment groups, high dose vitD supplementation of mothers provides a safe and effective alternative to direct supplementation of infants.
Figure 1: This graph displays the differences in infant spine bone mineral content (BMC) between the 400 IU and 6400 IU treatment groups at 1, 4 and 7 months of age.
Figure 2: Figure 1: This graph displays the differences in infant spine bone mineral density (BMD) between the 400 IU and 6400 IU treatment groups at 1, 4 and 7 months of age.
Table 1: This table shows the mean difference in spinal bone mineral content (BMC) and the mean difference in spinal bone mineral density (BMD) among the two treatment groups over the period of 1-7 months.
Authors/Institutions: Laura Andrews, Medical University of South Carolina, Charleston, South Carolina, United States; Kristen Phlegar, Medical University of South Carolina, Charleston, South Carolina, United States; John E. Baatz, Medical University of South Carolina, Charleston, South Carolina, United States; Myla Ebeling, Medical University of South Carolina, Charleston, South Carolina, United States; Judy R. Shary, Medical University of South Carolina, Charleston, South Carolina, United States; Cynthia n. Howard, University of Rochester Medical Center, Rochester, New York, United States; Ruth A. Lawrence, University of Rochester Medical Center, Rochester, New York, United States; Bruce Hollis, Medical University of South Carolina, Charleston, South Carolina, United States; Carol L. Wagner, Medical University of South Carolina, Charleston, South Carolina, United States