Is Provitamin A Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Provitamin A? Is Provitamin A safe for nursing mother and child? Does Provitamin A extracts into breast milk? Does Provitamin A has any long term or short term side effects on infants? Can Provitamin A influence milk supply or can Provitamin A decrease milk supply in lactating mothers?

Natural vitamin A precursor. It is found in vegetables. It has been marketed as ophthalmologic and laxative compounds in Spain which are free of risk.

Beta-carotene is a plant pigment that is converted into vitamin A in the body. Maternal vitamin A requirements are increased during lactation, but there are no specific guidelines for increased beta-carotene intake or indications for high-dose supplementation in nursing mothers. Typical beta-carotene intake in a Western diet is 6 to 8 mg daily. Beta-carotene is a normal component of human colostrum and mature milk, where it contributes to antioxidant defenses in the neonate.[1] Average concentrations are 1.12 mg/L and 230 mcg/L, respectively, in the Unites States.[2] Beta-carotene supplementation during pregnancy and for 6 months postpartum in nursing mothers with poor diets in a resource-poor setting reduced the number of days of illness in the mothers,[3] but does not reduce infant morbidity or mortality according to another study.[4] The bioavailability of beta-carotene is dependent on the fat content of the meal and the form in which it is administered, with synthetic pharmaceutical forms having the best bioavailability. High-dose beta-carotene supplements lead to a slow increase in breastmilk beta-carotene concentrations, with an accumulation half-life of about 9 days. Levels drop towards baseline slowly over several weeks after discontinuation. In general, beta-carotene is well tolerated, although excessive maternal intake of beta-carotene can lead to a harmless, reversible discoloration of the breastfed infant's skin.[5] In HIV-infected women, high-dose beta-carotene plus vitamin A supplementation increases the rate of HIV viral shedding into breastmilk and increases HIV infection in breastfed infants, although the mortality rate over the first 2 years of life is not increased.[6][7] The viral shedding may be a result of an increase in subclinical mastitis caused by beta-carotene.[8] Beta-carotene concentration in breastmilk is not affected by refrigeration, freezing, or low-temperature microwaving. The concentration does decrease when milk passes through a tube feeding system, regardless of light exposure.[9]Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information #about dietary supplements# is available elsewhere on the LactMed Web site.

A nursing mother was eating 2 to 3 pounds of carrots a week as raw and cooked carrots. The mother's skin was yellow in color, but her sclera were clear. At 2 months of age, her breastfed infant was diagnosed as having jaundice because of a yellow coloration of the skin. Breastfeeding was discontinued and the infant's skin returned to a normal color. The mother continued her diet and examination of the maternal serum found elevated levels of beta-carotene which was probably the cause of her infant's skin discoloration.[5] HIV-infected women in Tanzania received 1 of 4 supplements during pregnancy and lactation in a series of studies. Groups received either multivitamins (thiamine, riboflavin, vitamin B6, niacin, vitamin B12, vitamin C, vitamin E, and folic acid), multivitamins plus vitamin A and beta-carotene, vitamin A and beta-carotene alone, or placebo daily. The beta-carotene dose was 30 mg. At 24 months of age, the multivitamin-supplemented group's infants had significantly better growth parameters than the other groups.[16] One study found that the infants of mothers supplemented with vitamin A and beta-carotene had a higher rate of HIV transmission than those supplemented with multivitamins alone or placebo.[6] After 6 months postpartum, women who received vitamin A plus beta-carotene had greater shedding of the HIV virus into breastmilk than women who had not; multivitamins without vitamin A and beta-carotene did not increase viral shedding.[6] Beta-carotene appeared to have a shedding effect that was independent of vitamin A.[7] One possible explanation comes from another similar study in which those who received vitamin A plus beta-carotene alone had a 45% increased risk of severe subclinical mastitis and those who received multivitamins plus vitamin A and beta-carotene had a 29% increased risk of severe subclinical mastitis.[8]