What are the effects of Vitamin E supplementation during lactation (breastfeeding)?

From the Guidelines

Vitamin E supplementation during lactation is generally not necessary for most breastfeeding mothers who maintain a balanced diet, with a recommended daily intake of 15 mg as suggested by the World Health Organization 1.

Key Considerations

• The recommended dietary allowance (RDA) for vitamin E during lactation can typically be achieved through foods like nuts, seeds, vegetable oils, and leafy greens.
• For mothers with documented vitamin E deficiency, supplementation may be considered under medical supervision, usually at doses of 100-400 IU daily.
• Excessive vitamin E supplementation should be avoided as high doses (above 1,000 mg or 1,500 IU daily) may increase bleeding risk and potentially cause other adverse effects.

Transfer to Breast Milk

• Vitamin E transfers into breast milk, helping to protect the infant from oxidative stress and supporting immune function and neurological development.
• Most infants receive adequate vitamin E through breast milk when the mother has sufficient intake.

Supplementation Guidance

• If supplementation is needed, it's best to use the natural form (d-alpha-tocopherol) rather than synthetic forms (dl-alpha-tocopherol), as the natural form is more bioavailable and effectively transferred to breast milk.

Evidence Base

• The World Health Organization recommends a daily intake of 15 mg of vitamin E for lactating women 1, which is consistent with the goal of maintaining a balanced diet to support both maternal and infant health.

From the Research

Vitamin E Supplementation in Lactation

• Vitamin E supplementation in lactating women can increase the concentration of alpha-tocopherol (α-TOH) in colostrum, with natural α-TOH supplementation being more efficient than synthetic α-TOH supplementation 2.
• The alpha-tocopherol concentration in human milk decreases during lactation, until mature milk appears, and maternal variables such as parity, anthropometric nutritional status, socioeconomic status, and habitual dietary intake do not appear to affect the alpha-tocopherol levels in milk 3.
• The possible intake of colostrum and transitional milk can meet the nutritional requirement of the infant, but mature milk may provide smaller amounts of vitamin E 4.

Factors Influencing Vitamin E Levels in Human Milk

• Maternal age, gestational age, biochemical nutritional status in alpha-tocopherol, and maternal supplementation with vitamin E can have conflicting results on the alpha-tocopherol concentration in human milk 3.
• The phase of lactation is a significant factor influencing vitamin E content in milk, with alpha-tocopherol levels decreasing during lactation 3, 4.

Health Consequences of Inadequate Vitamin E Status

• Inadequate dietary α-tocopherol intakes can lead to increased infection, anemia, stunting of growth, and poor outcomes during pregnancy for both the infant and the mother 5.
• Plasma α-tocopherol concentrations <12 μmol/L are associated with increased adverse health consequences, and additional vitamin E has reversed the symptoms in some cases 5.

Antioxidant Content of Human Breastmilk and Infant Urine

• Supplementation of the diet of breastfeeding mothers with vitamin C and E can improve the antioxidant content of breastmilk and evidence of antioxidant activity in infant urine 6.
• The total antioxidant content of breastmilk and infant urine can be increased by supplementation with vitamin C and E, providing a positive effect on the antioxidant status of both mothers and infants 6.