Background: Despite the higher prevalence of vitamin D deficiency in blacks, the vitamin D
status of black preterm infants remains unknown. In addition, with the combination of parenteral
and enteral nutritional support that preterm infants receive, the effect of vitamin D–deficient
breast milk on vitamin D status is unknown.
Objective: To evaluate vitamin D status of preterm infants through the first month after delivery
and compare status by race and feeding type.
Study Design: Thirty-six (36) preterm (≤32 weeks gestation) infants (19 black, 17 white) had
assessment of feeding type, vitamin D intake, and serum 25-hydroxyvitamin D [25(OH)D] as
a marker of vitamin D status at three time points in the first month after delivery.
Results: Black infants had a significantly lower mean 25(OH)D level on day 7–8 and day
14–15 evaluations than white infants [14.9 ± 6.6 versus 23.3 ± 9.3 ng/mL (p = 0.021) and 18.3 ±
7.3 versus 25.6 ± 10.3 ng/mL (p = 0.048), respectively], but the difference was no longer significant
by day 28–30 evaluation [19.6 ± 7.7 versus 26.2 ± 11.6 ng/mL (p = 0.26)]. Vitamin D
status was not significantly lower in infants receiving predominantly breast milk (p = 0.6).
Vitamin D intake rose through the month as the amount and caloric density of enteral nutrition
increased. Six infants had significant decrease in serum 25(OH)D values from day 14–15
to day 28–30 evaluation despite receiving > 400 IU/day vitamin D.
Conclusion: Differences in vitamin D status occurred between black and white infants and
were significant through the first 2 weeks after delivery. Infants receiving predominantly
breast milk did not have significantly worse vitamin D status than those receiving formula.
The significant decline in serum 25(OH)D status observed in 28% of the infants was not related
to breast milk intake.
