Last update: June 10, 2018
Minimal risk for breastfeeding and infant.
There are several substances, natural or synthetic, that form the vitamin E complex.
The most important component are the tocopherols, the α-tocopherol being the most active and widely distributed in nature. Beta, gamma and delta tocopherol are also natural. Tocotrienols are also vitamin E.
Natural alpha-tocopherols are d-isomers. The dl form, less active, is synthetic.
The daily vitamin E requirements for a breastfeeding mother are 12 to 19 mg (28 IU) daily; and for an infant in the first year of life, 4 to 5 mg (6 to 8 IU) (NIH 2016, Ares 2015, Hall 2010).
No supplements are necessary if diet and nutritional status are adequate.
Supplementation does not increase milk levels in well-nourished women, but does so in those with low nutritional status.
The concentration of vitamin E (α-tocopherol) is highest in colostrum (6.5 to 15 mg/L) (Xue 2017, Melo 2017) and drops to half/a third in transition milk and a third/a fifth in mature milk (Xue 2017, Silva 2017, Jiang 2016, Lima 2014).
The high concentration of α-tocopherol in colostrum causes breastfed newborns to reach adult plasma levels of vitamin E (initially one third of them) in 4 to 6 days (Ostrea 1986).
The first week’s milk of mothers of premature babies and of children over 4kg at birth has a higher content of α-tocopherol (Grilo 2013, Gross 1985). Alpha tocopherol may be slightly decreased in mature milk after high-risk pregnancies (Sámano 2017).
Preterm infants with preterm breast milk had a higher plasma level of vitamin E than those fed with mature milk and both groups had a higher level than those fed artificial formula (Gross 1985).
Breastmilk contains greater contcentration of vitamin E than cow's milk. In the first year of life, breastfed infants had better plasma vitamin E levels than non-breastfed infants (Martínez 1984).
Maternal vitamin E supplementation increases the concentration of vitamin E in colostrum and transition milk (Melo 2017, Pires 2016, Clemente 2015), but not in mature milk (Pires 2016) and no relationship has been found between diet and the concentration of α-tocopherol in breastmilk (Jiang 2016). Maternal vitamin E deficiency is not related to breastmilk levels (da Silva 2016).
The contribution of vitamins of the B complex and vitamins C and E to HIV+ mothers improves the weight gain of their infants (Villamor 2005).
The topical application of vitamin E on the nipples of breastfeeding mothers over 6 days caused a significant increase in the plasma levels of vitamin E in the infants, who did not show adverse effects (Marx 1985).
We do not have alternatives for Vitamin E since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.
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