EVALUATION OF POSTPARTUM SUPPLEMENTATION WITH VITAMIN AND ON THE CONCENTRATION OF RETINOL IN SERUM AND MATERNAL MILK
Vitamin A. Alpha-tocopherol. Dietary supplementation. Puerperium. Human milk. Vitamin A Deficiency.
One of the main public health problems in the world is vitamin A deficiency, and postpartum supplementation is a strategy to combat this deficiency. Thus, this study has as main objective to evidence the effect of supplementation, in the immediate postpartum, with alpha-tocopherol on the concentration of retinol in serum and human milk up to 60 days postpartum. This study was prospective, controlled, randomized, starting with 80 women attended for delivery in two public maternity hospitals in Rio Grande do Norte. In the immediate postpartum period, these women were allocated to the control groups (n = 18) without any intervention; supplemented 1 (n = 16) receiving the dose of 400 IU RRR-alpha-tocopherol; and supplemented 2 (n = 19) receiving the dose of 800 IU of RRR-alpha-tocopherol. Maternal blood was collected in four moments: 1o (0 hour), 20o and 30o and 60o days postpartum, as well as the collection of maternal milk in the following moments: 1o (0 hours), 2o (24 hours), 7th, 20th, 30th and 60th days postpartum. Retinol and alpha-tocopherol were analyzed by High Performance Liquid Chromatography. The serum concentrations of maternal retinol and alpha-tocopherol at 0 hour did not differ between groups (p> 0.005), being indicative of adequate nutritional status. Supplementation with the 800 IU dose of RRR-alpha-tocopherol guaranteed higher circulating concentrations of alpha-tocopherol up to 20 days postpartum and retinol up to 30 days. The impact of alpha-tocopherol supplementation on the concentration of retinol in breast milk can be observed both in the group receiving the 400 IU dose of RRR-alpha-tocopherol and the one that received the dose of 800 IU, as it caused an increase in concentration of retinol 24 hours after supplementation. Evaluating the supply in relation to the daily requirement of vitamin A, the supplementary group 1 included the requirement established for infants up to 6 months of age (400 g / day) only in the milk production up to 24 hours postpartum and supplemented group 2 supplemented the daily vitamin A requirement of the infant until the 20th day after delivery. Regarding the analysis of alpha-tocopherol in breast milk, the increase in alpha-tocopherol concentration provided 24 hours after supplementation was high in both supplemented groups, but in group 2 this increase was maintained until the 7th day of the study. Thus, it was concluded that vitamin E supplementation administered in the immediate postpartum period offered improvements in the maternal nutritional status in relation to vitamin A and also its milk supply during the course of this study, and this increase in retinol is greater dose of vitamin E administered.