Last update Sept. 6, 2022
Very Low Risk
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 (Keikha 2021, 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), although higher levels of vitamin E in breast milk were associated with a higher intake of polyunsaturated fatty acids. (da Mata 2020)
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 team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2012 of United States of America
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