Table 7.

Summary effect of nutritional vitamins supplements on status of multiple vitamins human milk composition

First author surname, citation number	Type of Supplement	Characteristics of Participants	Type of study	Aim	Type of Nutrients Evaluated in Milk	Main findings	Jadad scale points and WHO divisions
Canfield [67]	Purified b-carotene in capsules	Five healthy mothers, between the ages of 23 and 36 years.	Randomized clinical trial	Investigate changes in concentrations of milk and serum carotenoids, retinol, and a-tocopherol of five healthy women over a 28-d supplementation trial with 30 mg b-carotene and for 4 wk. thereafter.	milk a-tocopherol and retinol	B Carotene supplementation increased mean b-carotene concentrations in milk and serum 6.4- and 7.4-fold, respectively. Concentrations of other major carotenoids, retinol, and a-tocopherol did not change substantially in either milk or serum.	3/5 Americas (AMRO)
Garcia [68]	One retinyl palmitate capsule (200,000 UI)	73 Healthy parturient women, control (n = 37) and supplemented (n = 36).	Randomized clinical trial	To determine the effect of maternal supplementation with a megadose of retinyl palmitate in the immediate post-partum on a-tocopherol concentration in the colostrums.	Retinol, a-tocopherol	A significant increase (P = 0.00) was observed in colostrums retinol in the supplemented group 24 h after administration of the retinyl palmitate capsule. A significant increase (P = 0.04) was also found in colostrums a-tocopherol concentration after vitamin A supplementation.	1/5 Americas (AMRO)
Gossage [29]	B-carotene (30 mg/d; n = 11) or placebo (n = 10) beginning on day 4 postpartum (day 0 of the study).	Twenty-one pregnant women were recruited during their last trimester.	Randomized clinical trial	To assess milk carotenoid concentrations during days 4–32 postpartum and the effects of maternal B-carotene supplementation.	lutein + zeaxanthin, b-cryptoxanthin, lycopene, a-carotene, B-carotene, retinol, and a-tocopherol.	B-carotene supplementation did not significantly change the milk concentrations of B –carotene, the other carotenoids, retinol, or tocopherol. There were no significant overall effects of carotene supplementation on milk concentrations of lutein, cryptoxanthin, lycopene, or carotene.	2/5 Americas (AMRO)
Sherry [69]	Either 0 mg/d of lutein (placebo), 6 mg/d of lutein (low-dose), or 12 mg/d of lutein (high-dose).	Eighty-nine lactating women 4–6 wk. postpartum.	A multisite, prospective, randomized, placebo controlled dose-response study	To determine the impact of lutein supplementation in the breast milk and plasma of lactating women and in the plasma of breast-fed infants 2–3 mo postpartum.	Carotenoids, Lutein, zeaxanthin	Total lutein + zeaxanthin concentrations were greater in the lowand high-dose–supplemented groups than in the placebo group in breast milk (140 and 250%, respectively; P < 0.0001)	5/5 Americas (AMRO)
Webb [70]	(1) vitamin A and b-carotene (VABC: 5000 IU (1500 mg retinol activity equivalents) of preformed vitamin A plus 30 mg of b-carotene), (2) multivitamins (MV) that did not include vitamin A and b-carotene (20 mg of thiamine, 20 mg of riboflavin, 25 mg of vitamin B6, 100 mg of niacin, 50 mg of vitamin B12, 500 mg of vitamin C (purified L-ascorbic acid), 30 mg of vitamin E RRR-a- tocopherol acetate) and 0.8 mg of folic acid), (3) MV that included vitamin A and b-carotene (same doses as above), or (4) placebo.	1078 HIV-infected pregnant women.	A randomized, double-blind, placebo-controlled trial	To assess the impact of daily vitamin supplementation during pregnancy and lactation on concentrations of retinol, b-carotene, a-carotene, a-tocopherol, g-tocopherol and d-tocopherol in breast milk.	retinol, total b-carotene, a-carotene, a-tocopherol, d-tocopherol and g-tocopherol	Women who received VABC had significantly higher concentrations of breast milk retinol, b-carotene and acarotene at all-time points during the first year postpartum compared to women who did not receive VABC. Supplementation with VABC did not influence concentrations of a-, g- or d-tocopherol from delivery to 1 year postpartum.	4/5 Africa (AFRO)