Daily Oral Low-Dose Vitamin A Supplementation Increases the Retinol Levels in Serum and Breast Milk of Lactating Mothers and Has No Effect on Infant Health Status: A Randomized Placebo-Controlled Trial in China

Background: Vitamin A supplementation has been advocated as a potential strategy to improve the vitamin A status of lactating mothers and infants. In China, vitamin A supplements are readily available in the form of daily oral low doses. However, the existing clinical trials are limited to single or two high-dose maternal administration.Objective: We aimed to evaluate the effects of the daily oral low-dose vitamin A supplementation on the retinol levels in serum and breast milk of lactating mothers and the health status of infants in China.Methods: Lactating mothers who met the inclusion criteria and planned to continue exclusive breast-feeding were randomly assigned to receive either daily oral vitamin A and D drops (one soft capsule of 1800IU vitamin A and 600IU vitamin D2), or a matching placebo for 2 months. Before and after the intervention, the dietary intake was investigated by instant photography, and the retinol concentration in maternal serum and breast milk was determined by UPLC. During the trial, the health status of infants was diagnosed by pediatrician or reported by lactating mothers.Results: 245 participants completed the study with 117 in supplementation group and 128 in control group. After the 2-month intervention, maternal serum retinol concentration increased in supplementation group with no change in control group. Although breast milk retinol concentrations decreased significantly in both groups, the decrease in supplementation group was significantly less than that in the control group. However, maternal vitamin A supplementation was not associated with lower risks of infant febrile illness, respiratory tract infection, diarrhea and eczema respectively. Conclusion: Daily oral low-dose vitamin A supplementation is helpful to improve the maternal vitamin A status and can also play a positive role in vitamin A status of infants through breast milk.