REGULAR ARTICLE Vitamin D Status of term exclusively breastfed infants and their mothers from India N Agarwal 1 , MMA Faridi (mmafaridi@yahoo.co.in; drmmafaridi@gmail.com) 1 , A Aggarwal 1 , O Singh 2 1.Department of Pediatrics, University College of Medical Sciences, University of Delhi, New Delhi, India 2.Department of Immunoendocrinology, National Institute of Immunology, New Delhi, India Keywords 25-OH Vitamin D, Exclusive breastfeeding, Infants, Rickets, Vitamin D deficiency Correspondence Dr MMA Faridi, E-11, GTB Hospital Campus, Dilshad Garden, Delhi -110095, India. Tel: 0091-98683 99740 | Fax: 0091-11-2259 0495 | Email: mmafaridi@yahoo.co.in; drmmafaridi@ gmail.com Received 30 December 2009; revised 14 April 2010; accepted 1 June 2010. DOI:10.1111/j.1651-2227.2010.01912.x ABSTRACT Objectives: (i) To measure 25-OH vitamin D levels in term infants at 10 weeks and 6 months and to correlate with maternal vitamin D levels at 10-week postpartum (ii) To evaluate infants at 6 months for rickets. Patients and methods: A total of 179 exclusively breastfed infant–mother pairs 96 appropriate-for-gestational age (Group 1) and 83 small- for- gestational age infants (Group 2) recruited at 10 weeks. At 6 months, 52 in group 1 and 45 in group 2 were evaluated. Venous blood sample were collected at 10 weeks and 6 months in infants and at 10 weeks in mothers for calcium, phosphorus, alkaline phosphatase and 25-OH vitamin D estimation. Results: Mean 25-OH vitamin D levels of infants (n = 97) were 11.55 ± 7.17 ng / mL at 10 weeks and 16.96 ± 13.33 ng / mL at 6 months (p < 0.001). Mean vitamin D levels of infants in group 1 and group 2 did not differ at recruitment and 6 months (p > 0.05)). Maternal vitamin D levels in group 1 and group 2 were 8.89 ± 5.97 and 9.87 ± 6.44 ng / mL, respectively (p = 0.44). Significant correlation was observed between 25-OH vitamin D of infants and mothers (p < 0.05). At 10 weeks, 55.67% infants, 70% mothers and at 6 months, 44.33% infants had vitamin D < 11 ng / mL. At 6 months, 16.49% infants developed rickets. Conclusion: Exclusively breastfed infants and their mothers are Vitamin D deficient, hence the need to improve vitamin D status. INTRODUCTION Exclusive breastfeeding is recommended for 6 months because breast milk is considered optimal in both micro and macronutrients (1). Fact that breast milk is adequate in macronutrients is well established (2). However, there is a controversy whether breast milk can provide adequate amount of vitamin D to an exclusively breastfed (EBF) infant because human milk contains only 15–50 IU / L of vitamin D activity, too low, to provide recommended daily requirement of 400 IU / day (3,4). The recent recommenda- tion of AAP is to supplement 400 IU units of vitamin D to breastfed infants (5). Many studies have reported that EBF babies develop vita- min D deficiency in infancy and early childhood (6,7). High prevalence of vitamin D deficiency in healthy mothers and their newborns have been reported from Asian and Euro- pean countries ostensibly because of poor sunlight exposure (6,8). Some studies have also shown that unsupplemented breastfed infants show no evidence of vitamin D deficiency during the first 6 months of life if their mothers had ade- quate vitamin D stores or sufficient sunlight exposure (9,10). We, thus, have no conclusive evidence to comment on the status of 25-OH vitamin D levels in term exclusively breastfed infants and need of supplementation of vitamin D in them. Hence, the aim of this study was to find out vitamin D status of term exclusively breastfed infants at 10 weeks and 6 months of age and to correlate serum vitamin D levels of these infants with maternal vitamin D levels measured at 10-week postpartum. SUBJECTS AND METHODS This prospective study was conducted in the Department of paediatrics of a tertiary care teaching hospital in Delhi, India from January 2006 to February 2007 after getting approval from the Ethical Committee. Infants were enrolled from the Immunization Clinic at 10 weeks of age after obtaining written informed consent from the parents. Study was carried out in urban population of Delhi, India, majority of patients belonged to lower socioeconomic sta- tus. The mother–baby pairs were followed up to 6 months of age. Acta Pædiatrica ISSN 0803–5253 ª2010 The Author(s)/Journal Compilation ª2010 Foundation Acta Pædiatrica/Acta Pædiatrica 2010 99, pp. 1671–1674 1671