Vitamins lactation

The typical U.S. daily diet contains 1.1—3.6 mg of vitamin B, most coming from meats and vegetables. Poor diets may provide less than half of these amounts and less than the RDA. Some populations require higher amounts persons with high protein intakes, pregnant and lactating women, users of oral contraceptives, alcohoHcs, users of dmgs which interfere with vitamin B function, and those afflicted with some diseases. Several reviews have examined the relationship of vitamin B and specific diseases in more detail (4,23). 

Vitamin C requirements are increased during pregnancy and lactation, in patients undergoing hemodialysis and in smokers. Seniors often have suboptimal intakes. 

The salicylates are used cautiously in patients witii hepatic or renal disease, preexisting hypoprotiirombine-mia, or vitamin K deficiency and during lactation. The dragp are also used with caution in patients with gastrointestinal irritation such as peptic ulcers and in patients with mild diabetes or gout. 

The bile acid sequestrants are contraindicated in patients with known hypersensitivity to the drugs. Bile acid sequestrants are also contraindicated in those with complete biliary obstruction. These drags are used cautiously in patients with a history of liver or kidney disease Bile acid sequestrants are used cautiously during pregnancy (Pregnancy Category C) and lactation (decreased absorption of vitamins may affect the infant). 

Armario, A., Campmany, L., Borras, M. and Hidalgo, J. (1990). Vitamin E-supplemented diets reduce lipid peroxidation but do not alter either pituitary-adrenal, glucose, and lactate responses to immobilization stress or gastric ulceration. Free Rad. Res. Commun. 9, 113-118. 

Check parathyroid hormone (PTH), vitamin D and precursors, magnesium, and phosphate levels ° Pharmacological causes of decreased ionized calcium may include excess infusions of citrate, EDTA, lactate, fluoride poisoning, foscarnet, cinacalcet, bisphosphates, or unrelated increase in serum phosphate or decrease in serum magnesium levels... 

There are fewer data on the frequency of medication use during lactation. Use does appear to be common. A recent Dutch study reported that 53% of all breast-feeding mothers had taken a medication, herb, or supplement (exclusive of iron, vitamins, and homeopathic remedies).5 Furthermore, more women in the United States are now abiding by the recommendation to breast-feed. It is now estimated that up to 50% of United States women breast-feed for at least a short time.6... 

Majee D N, Schwab E C, Bertics S J, Seymour W M and Shaver R D (2003), Lactation performance by dairy cows fed supplemental biotin and a B-vitamin blend , Journal of Dairy Science, 86, 2106-2112. 

The RDI/RDA for vitamin A for adult males is 900 micrograms/day (0.9 mg/day) and for adult females 700 micrograms/day (0.7 mg/day). Children require significantly less and lactating women significantly more. There are a number of excellent sources of vitamin A fish, dairy products, liver, leafy vegetables, and dark-colored fruits. 

The RDl for vitamin D is 5 micrograms/day for men and women, adults and children, a value independent of state of pregnancy or lactation. Middle-aged adults, ages 50-70 years old, require 10 micrograms/day and for those over 70 years old the valne goes np to 15 micrograms/day. Fish oils, the flesh of fatty fish, and fortified milk and cereals are excellent sources of vitamin D. Of course, vitamin D is also present in most multivitamin piUs. 

Riboflavin is also known as vitamin B2. It contains a complex isoalloxazine ring that humans are unable to synthesize. The complex ring is hooked onto a live-carbon sugar derivative, ribitol, closely related to the ribose that occurs in RNA. The RDA for adult males is 1.3 mg/day and for adult females 1.1 mg/day. Values decrease with increasing age but increase in pregnancy and lactation. Organ meats, milk, bread products, and fortified cereals are substantial sources of riboflavin. 

Depending on age, adult men require 1.3-1.7 mg/day and adult women 1.3-1.5 mg/day. Women who are pregnant or lactating require 1.9-2.0 mg/day. Deficiency of vitamin Be in the developed world is rare as many foods are good... 

The RDA for pantothenic acid in adult men and women is 5 mg/day. Pregnant and lactating women need, respectively, 6 and 7 mg/day. As usual, children need less. Organ meats, milk, bread products, and fortified cereals are excellent sources of this vitamin. There are no reports of pantothenic acid toxicity and there is no established... 

Orotic acid in the diet (usually at a concentration of 1 per cent) can induce a deficiency of adenine and pyridine nucleotides in rat liver (but not in mouse or chick liver). The consequence is to inhibit secretion of lipoprotein into the blood, followed by the depression of plasma lipids, then in the accumulation of triglycerides and cholesterol in the liver (fatty liver) [141 — 161], This effect is not prevented by folic acid, vitamin B12, choline, methionine or inositol [141, 144], but can be prevented or rapidly reversed by the addition of a small amount of adenine to the diets [146, 147, 149, 152, 162]. The action of orotic acid can also be inhibited by calcium lactate in combination with lactose [163]. It was originally believed that the adenine deficiency produced by orotic acid was caused by an inhibition of the reaction of PRPP with glutamine in the de novo purine synthesis, since large amounts of PRPP are utilized for the conversion of orotic acid to uridine-5 -phosphate. However, incorporation studies of glycine-1- C in livers of orotic acid-fed rats revealed that the inhibition is caused rather by a depletion of the PRPP available for reaction with glutamine than by an effect on the condensation itself [160]. 

Lactation Vitamin B-12 is excreted into breast milk. 

Oral As a dietary supplement when calcium intake may be inadequate. Conditions that may be associated with calcium deficiency include the following Vitamin D deficiency, sprue, pregnancy and lactation, achlorhydria, chronic diarrhea, hypoparathyroidism, steatorrhea, menopause, renal failure, pancreatitis, hyperphosphatemia, and alkalosis. Some diuretics and anticonvulsants may precipitate hypocalcemia, which may validate calcium replacement therapy. Calcium salt therapy should not preclude the use of other corrective measures intended to treat the underlying cause of calcium depletion. 

Lactation Vitamin B-12 is excreted in breast milk in concentrations that approximate the mother s vitamin B-12 blood level. Amounts of B- 2recommended by the Food and Nutrition Board, National Academy of Sciences-National Research Council (2.6 mcg/day) should be consumed during lactation. 

Lactation Exercise caution when administering to a nursing woman. The possible lack of proper vitamin absorption may have an effect on nursing infants. 

D3 Cholecalciferol Mackerel, sardines, salmon and some foods fortified with vitamin D >71 yr 12.5-15 pg, idem pregnancy (2nd and 3rd trimester) lactation 7.5-10 pg, idem... 

Reference Intakes (DRIs). In the past, the recommended dietary allowances (RDAs), which are the levels of intake of essential nutrients that are considered to be adequate to meet the known nutritional needs of practically all healthy persons, were the primary reference value for vitamins and other nutrients. The DRIs also include other reference values, such as the estimated average requirement (EAR) and the adequate intake (AI). The RDA, EAR, and AI reference standards define nutritional intake adequacy. Since these recommendations are given for healthy populations in general and not for individuals, special problems, such as premature birth, inherited metabolic disorders, infections, chronic disease, and use of medications, are not covered by the requirements. Separate RDAs have been developed for pregnant and lactating women. Vitamin supplementation may be required by patients with special conditions and for those who do not consume an appropriate diet. 

Folic acid deficiency symptoms include megaloblastic anemia, glossitis, diarrhea, and weight loss. The requirement for this vitamin increases during pregnancy and lactation. 

The dehciency disease associated with a lack of ascorbic acid is called scurvy. Early symptoms include malaise and follicular hyperkeratosis. Capillary fragility results in hemorrhages, particularly of the gums. Abnormal bone and tooth development can occur in growing children. The body s requirement for vitamin C increases during periods of stress, such as pregnancy and lactation. 

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