![[Feedback]](/icons/banner/feedbackACT.gif){kind=icon}
![[For Subscribers]](/icons/banner/subscriberACT.gif){kind=icon}
![[Archive]](/icons/banner/archiveACT.gif){kind=icon}
![[Search]](/icons/banner/searchACT.gif){kind=icon}
![[Contents]](/icons/banner/tocACT.gif){kind=icon}
|
|
|
|
|
||
a Center for Human Nutrition, The Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205 and b International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh 1000
The effects of maternal postpartum vitamin A or ß-carotene
supplementation on maternal and infant serum retinol concentrations,
modified relative dose-response (MRDR) ratios and breast milk vitamin A
concentrations were assessed during a community-based trial in Matlab,
Bangladesh. At 1–3 wk postpartum, women were randomly assigned to
receive either (1) a single dose of 200,000 international units
[60,000 retinol equivalents (RE)] vitamin A followed by daily
placebos (n = 74), (2) daily doses of ß-carotene
[7.8 mg (1300 RE)] (n = 73) or (3) daily placebos
(n = 73) until 9 mo postpartum. Compared to placebos,
vitamin A supplementation resulted in lower maternal MRDR ratios (i.e.,
increased liver stores) and higher milk vitamin A concentrations at 3
mo, but these improvements were not sustained. The ß-carotene
supplementation acted more slowly, resulting in milk vitamin A
concentrations higher than the placebo group only at 9 mo. Irrespective
of treatment group, over 50% of women produced milk with low vitamin A
concentrations (
1.05 µmol/L or 0.28 µmol/g fat) throughout the
study. Overall, mean maternal serum retinol concentrations were not
affected by supplementation. Compared to the placebo group, the mean
MRDR ratio of 6-mo-old infants was higher in the vitamin A group.
Infants (33%) had serum retinol concentrations <0.70 µmol/L and
88% had MRDR ratios 
0.06. We conclude that while both interventions
were beneficial, neither was sufficient to correct the underlying
subclinical vitamin A deficiency in these women nor to bring their
infants into adequate vitamin A status.
KEY WORDS: • humans • lactation • vitamin A • ß-carotene • supplementation
This article has been cited by other articles:
|
|
 |
|
  R. D.W. Klemm, A. B. Labrique, P. Christian, M. Rashid, A. A. Shamim, J. Katz, A. Sommer, and K. P. West Jr Newborn Vitamin A Supplementation Reduced Infant Mortality in Rural Bangladesh Pediatrics, July 1, 2008; 122(1): e242 - e250. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Idindili, H. Masanja, H. Urassa, W. Bunini, P. van Jaarsveld, J. J Aponte, E. Kahigwa, H. Mshinda, D. Ross, and D. M Schellenberg Randomized controlled safety and efficacy trial of 2 vitamin A supplementation schedules in Tanzanian infants Am. J. Clinical Nutrition, May 1, 2007; 85(5): 1312 - 1319. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. K Tchum, S. A Tanumihardjo, S. Newton, B. de Benoist, S. Owusu-Agyei, F. K. Arthur, and A. Tetteh Evaluation of vitamin A supplementation regimens in Ghanaian postpartum mothers with the use of the modified-relative-dose-response test Am. J. Clinical Nutrition, December 1, 2006; 84(6): 1344 - 1349. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L. Surles, J. Li, and S. A. Tanumihardjo The Modified-Relative-Dose-Response Values in Serum and Milk Are Positively Correlated over Time in Lactating Sows with Adequate Vitamin A Status J. Nutr., April 1, 2006; 136(4): 939 - 945. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. L Penniston and S. A Tanumihardjo The acute and chronic toxic effects of vitamin A Am. J. Clinical Nutrition, February 1, 2006; 83(2): 191 - 201. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Akohoue, J. B. Green, and M. H. Green Dietary Vitamin A Has Both Chronic and Acute Effects on Vitamin A Indices in Lactating Rats and Their Offspring J. Nutr., January 1, 2006; 136(1): 128 - 132. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Piantedosi, N. Ghyselinck, W. S. Blaner, and S. Vogel Cellular Retinol-binding Protein Type III Is Needed for Retinoid Incorporation into Milk J. Biol. Chem., June 24, 2005; 280(25): 24286 - 24292. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. L Penniston and S. A Tanumihardjo Elevated serum concentrations of {beta}-glucuronide metabolites and 4-oxoretinol in lactating sows after treatment with vitamin A: a model for evaluating supplementation in lactating women Am. J. Clinical Nutrition, April 1, 2005; 81(4): 851 - 858. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. Kimmons, K. G. Dewey, E. Haque, J. Chakraborty, S. J. M. Osendarp, and K. H. Brown Low Nutrient Intakes among Infants in Rural Bangladesh Are Attributable to Low Intake and Micronutrient Density of Complementary Foods J. Nutr., March 1, 2005; 135(3): 444 - 451. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. R Valentine and S. A Tanumihardjo One-time vitamin A supplementation of lactating sows enhances hepatic retinol in their offspring independent of dose size Am. J. Clinical Nutrition, February 1, 2005; 81(2): 427 - 433. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. C Malaba, P. J Iliff, K. J Nathoo, E. Marinda, L. H Moulton, L. S Zijenah, P. Zvandasara, B. J Ward, the ZVITAMBO Study Group, and J. H Humphrey Effect of postpartum maternal or neonatal vitamin A supplementation on infant mortality among infants born to HIV-negative mothers in Zimbabwe Am. J. Clinical Nutrition, February 1, 2005; 81(2): 454 - 460. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A Dijkhuizen, F. T Wieringa, C. E West, and Muhilal Zinc plus {beta}-carotene supplementation of pregnant women is superior to {beta}-carotene supplementation alone in improving vitamin A status in both mothers and infants Am. J. Clinical Nutrition, November 1, 2004; 80(5): 1299 - 1307. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Tanumihardjo Assessing Vitamin A Status: Past, Present and Future J. Nutr., January 1, 2004; 134(1): 290S - 293. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Rahmathullah, J. M Tielsch, R D Thulasiraj, J. Katz, C. Coles, S. Devi, R. John, K. Prakash, A V Sadanand, N Edwin, et al. Impact of supplementing newborn infants with vitamin A on early infant mortality: community based randomised trial in southern India BMJ, July 31, 2003; 327(7409): 254. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Basu, B Sengupta, and P K R. Paladhi Single megadose vitamin A supplementation of Indian mothers and morbidity in breastfed young infants Postgrad. Med. J., July 1, 2003; 79(933): 397 - 402. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Umeta, C. E. West, H. Verhoef, J. Haidar, and J. G.A.J. Hautvast Factors Associated with Stunting in Infants Aged 5-11 Months in the Dodota-Sire District, Rural Ethiopia J. Nutr., April 1, 2003; 133(4): 1064 - 1069. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. L. Penniston, A. R. Valentine, and S. A. Tanumihardjo A Theoretical Increase in Infants' Hepatic Vitamin A Is Realized Using a Supplemented Lactating Sow Model J. Nutr., April 1, 2003; 133(4): 1139 - 1142. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Bahl, N. Bhandari, M. A. Wahed, G. T. Kumar, M. K. Bhan, and the WHO/CHD Immunization-Linked Vitamin A Group Vitamin A Supplementation of Women Postpartum and of Their Infants at Immunization Alters Breast Milk Retinol and Infant Vitamin A Status J. Nutr., November 1, 2002; 132(11): 3243 - 3248. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. P. West Jr. Extent of Vitamin A Deficiency among Preschool Children and Women of Reproductive Age J. Nutr., September 1, 2002; 132(9): 2857S - 2866. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. A. Tanumihardjo and K. L. Penniston Simplified methodology to determine breast milk retinol concentrations J. Lipid Res., February 1, 2002; 43(2): 350 - 355. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Tanumihardjo Can Lack of Improvement in Vitamin A Status Indicators Be Explained by Little or No Overall Change in Vitamin A Status of Humans? J. Nutr., December 1, 2001; 131(12): 3316 - 3318. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Lietz, C J. K Henry, G. Mulokozi, J. K. Mugyabuso, A. Ballart, G. D Ndossi, W. Lorri, and A. Tomkins Comparison of the effects of supplemental red palm oil and sunflower oil on maternal vitamin A status Am. J. Clinical Nutrition, October 1, 2001; 74(4): 501 - 509. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Muslimatun, M. K. Schmidt, C. E. West, W. Schultink, J. G. A. J. Hautvast, and D. Karyadi Weekly Vitamin A and Iron Supplementation during Pregnancy Increases Vitamin A Concentration of Breast Milk but Not Iron Status in Indonesian Lactating Women J. Nutr., October 1, 2001; 131(10): 2664 - 2669. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A Dijkhuizen, F. T Wieringa, C. E West, Muherdiyantiningsih, and Muhilal Concurrent micronutrient deficiencies in lactating mothers and their infants in Indonesia Am. J. Clinical Nutrition, April 1, 2001; 73(4): 786 - 791. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Tanumihardjo Vitamin A Status Assessment in Rats with 13C4-Retinyl Acetate and Gas Chromatography/Combustion/Isotope Ratio Mass Spectrometry J. Nutr., November 1, 2000; 130(11): 2844 - 2849. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Katz, K. P West Jr, S. K Khatry, E. K Pradhan, S. C LeClerq, P. Christian, L. S.-F. Wu, R. K Adhikari, S. R Shrestha, and A. Sommer Maternal low-dose vitamin A or {beta}-carotene supplementation has no effect on fetal loss and early infant mortality: a randomized cluster trial in Nepal Am. J. Clinical Nutrition, June 1, 2000; 71(6): 1570 - 1576. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. L Rice, R. J Stoltzfus, A. de Francisco, and C. L Kjolhede Evaluation of serum retinol, the modified-relative-dose-response ratio, and breast-milk vitamin A as indicators of response to postpartum maternal vitamin A supplementation Am. J. Clinical Nutrition, March 1, 2000; 71(3): 799 - 806. [Abstract] [Full Text] [PDF]
|
|
