Impact of Exclusive Breastfeeding on Vitamin D Status in Children Under Five in Karachi
Breastfeeding and Vitamin D Status in Karachi Children
DOI:
https://doi.org/10.62807/jowach.v2i1.2025.6-11Keywords:
Vitamin D deficiency, exclusive breastfeeding, children, public health, nutritionAbstract
Background:
Vitamin D deficiency poses a significant public health challenge, particularly for young children. While breastfeeding provides essential nutrients, its influence on vitamin D status in children remains unclear, especially in populations with high deficiency rates. This study evaluates the impact of exclusive breastfeeding on the vitamin D status of children under five in Karachi, Pakistan.
Methods:
This retrospective cross-sectional study included 400 children aged 0 to 5 years who underwent vitamin D testing at a diagnostic laboratory in Karachi in 2022. The study utilized logistic regression and multivariate analyses to examine the relationship between exclusive breastfeeding and vitamin D status, accounting for potential confounders.
Results:
The prevalence of vitamin D deficiency was 71.8%. Children exclusively breastfed for ≥6 months had a significantly lower risk of deficiency (OR: 0.60, 95% CI: 0.45-0.80, p < 0.001). Multivariate analysis confirmed that exclusive breastfeeding independently contributed to a reduced risk of deficiency, alongside age and seasonal factors.
Conclusions:
Promoting exclusive breastfeeding, coupled with safe sun exposure and dietary education, could reduce vitamin D deficiency in young children in Karachi. Public health strategies should integrate these findings to enhance childhood nutrition and health outcomes.
References
Chemes V. , Аbrahamovych О. , Abrahamovych U. , Ivanochko R. , & Kobak L.. Calcium-phosphorus metabolism and markers of its regulation in patients with rheumatoid arthritis with violation of bone mineral density: character and diagnostic value. Lviv Clinical Bulletin 2023;3-4(39-40):76-82. https://doi.org/10.25040/lkv2022.03-04.076
Saadon H.. Vitamin d deficiency in childhood: a review. University of Thi-Qar Journal of Science 2024;11(1):176-184. https://doi.org/10.32792/utq/utjsci/v11i1.1230
Tabassum A. , Ali A. , Zahedi F. , & Ismail N.. Immunomodulatory role of vitamin d on gut microbiome in children. Biomedicines 2023;11(5):1441. https://doi.org/10.3390/biomedicines11051441
Sánchez‐Zuno G. , González‐Estevez G. , Matuz-Flores M. , Macedo‐Ojeda G. , Hernández‐Bello J. , Mora J. et al.. Vitamin d levels in covid-19 outpatients from western mexico: clinical correlation and effect of its supplementation. Journal of Clinical Medicine 2021;10(11):2378. https://doi.org/10.3390/jcm10112378
Jordan T. , Siuka D. , Rotovnik N. , & Pfeifer M.. Covid-19 and vitamin d– a systematic review. Slovenian Journal of Public Health 2022;61(2):124-132. https://doi.org/10.2478/sjph-2022-0017
Al‐Hussaini A. , Alshehry Z. , Al-Dehaimi A. , & Bashir M.. Vitamin d and iron deficiencies among saudi children and adolescents. Saudi Journal of Gastroenterology 2022;28(2):157-164. https://doi.org/10.4103/sjg.sjg_298_21
Al‐Hussaini A. , Alshehry Z. , Al-Dehaimi A. , & Bashir M.. Vitamin d and iron deficiencies among saudi children and adolescents. Saudi Journal of Gastroenterology 2022;28(2):157-164. https://doi.org/10.4103/sjg.sjg_298_21
Cui A. , Zhang T. , Xiao P. , Fan Z. , Wang H. , & Zhuang Y.. Global and regional prevalence of vitamin d deficiency in population-based studies from 2000 to 2022: a pooled analysis of 7.9 million participants. Frontiers in Nutrition 2023;10. https://doi.org/10.3389/fnut.2023.1070808
Jiang Z. , Pu R. , Li N. , Chao-zhen C. , Li J. , Dai W. et al.. High prevalence of vitamin d deficiency in asia: a systematic review and meta-analysis. Critical Reviews in Food Science and Nutrition 2021;63(19):3602-3611. https://doi.org/10.1080/10408398.2021.1990850
Martens P. , Gysemans C. , Verstuyf A. , & Mathieu C.. Vitamin d’s effect on immune function. Nutrients 2020;12(5):1248. https://doi.org/10.3390/nu12051248
Chakhtoura M. , Rahme M. , Chamoun N. , & Fuleihan G.. Vitamin d in the middle east and north africa. Bone Reports 2018;8:135-146. https://doi.org/10.1016/j.bonr.2018.03.004
Webb A. , Kazantzidis A. , Kift R. , Farrar M. , Wilkinson J. , & Rhodes L.. Colour counts: sunlight and skin type as drivers of vitamin d deficiency at uk latitudes. Nutrients 2018;10(4):457. https://doi.org/10.3390/nu10040457
Pligt P. , Willcox J. , Szymlek‐Gay E. , Murray E. , Worsley A. , & Daly R.. Associations of maternal vitamin d deficiency with pregnancy and neonatal complications in developing countries: a systematic review. Nutrients 2018;10(5):640. https://doi.org/10.3390/nu10050640
Poh B. , Wong J. , Lee S. , Chia J. , Yeo G. , Sharif R. et al.. Triple burden of malnutrition among malaysian children aged 6 months to 12 years: current findings from seanuts ii malaysia. Public Health Nutrition 2023;27(1). https://doi.org/10.1017/s1368980023002239
Isa H. , Almaliki M. , Alsabea A. , & Mohamed A.. Vitamin d deficiency in healthy children in bahrain: do gender and age matter?. Eastern Mediterranean Health Journal 2020;26(3):260-267. https://doi.org/10.26719/emhj.19.084
Hribar M. , Žlavs K. , Pravst I. , & Žmitek K.. Validation of the food frequency questionnaire for the assessment of dietary vitamin d intake. Frontiers in Nutrition 2022;9. https://doi.org/10.3389/fnut.2022.950874
Arshad S. and Zaidi S.. Vitamin d levels among children, adolescents, adults, and elders in pakistani population: a cross-sectional study. BMC Public Health 2022;22(1). https://doi.org/10.1186/s12889-022-14526-6
Kapoor A. , Fatima F. , Naveed A. , Shaikh G. , Solangi D. , & Shanker B.. Vitamin d deficiency among well nourished and malnourished children of school going age at district tharparkar. Pakistan Journal of Medical and Health Sciences 2022;16(7):873-875. https://doi.org/10.53350/pjmhs22167873
Közler S. and Şaylı T.. Factors influencing initiation and discontinuation of vitamin d supplementation among infants. 2024. https://doi.org/10.22541/au.170666449.95013996/v1
Dawodu A. , Salameh K. , Al-Janahi N. , Bener A. , & Elkum N.. The effect of high-dose postpartum maternal vitamin d supplementation alone compared with maternal plus infant vitamin d supplementation in breastfeeding infants in a high-risk population. a randomized controlled trial. Nutrients 2019;11(7):1632. https://doi.org/10.3390/nu11071632
Tung K. , Wong R. , Tsang H. , Chan B. , Wong S. , So H. et al.. An assessment of risk factors for insufficient levels of vitamin d during early infancy. Nutrients 2021;13(4):1068. https://doi.org/10.3390/nu13041068
Heo JS, Ahn YM, Kim AE, Shin SM. Breastfeeding and vitamin D. Clin Exp Pediatr. 2022;65(9):418–429. https://doi.org/10.3345/cep.2021.00444
Durá-Travé T, Gallinas-Victoriano F. Pregnancy, breastfeeding, and vitamin D. Int J Mol Sci. 2023;24(15):11881. https://doi.org/10.3390/ijms241511881
Kazemain E, Ansari S, Davoodi SH, Patterson WB, Shakerinava P, Wagner CL, Amouzegar A. The effect of maternal vitamin D supplementation on vitamin D status of exclusively breastfeeding mothers and their nursing infants: A systematic review and meta-analysis of randomized clinical trials. Adv Nutr. 2022;13(2):568-585. Available from: https://doi.org/10.1093/advances/nmab126
M S. Study of vitamin D levels in exclusively breastfed term infants in a tertiary care centre. Int J Contemp Pediatr. 2017;5(1):71-74. Available from: https://doi.org/10.18203/2349-3291.ijcp20175425
DePender S, Russell MM, DeJager J, Comstock SS. Impact of maternal vitamin D supplementation during breastfeeding on infant serum vitamin D levels: A narrative review of the recent evidence. Children. 2022;9(12):1863. Available from: https://doi.org/10.3390/children9121863
Tan ML, Abrams SA, Osborn DA. Vitamin D supplementation for term breastfed infants to prevent vitamin D deficiency and improve bone health. Cochrane Database Syst Rev. 2020;(12):CD013046. Available from: https://doi.org/10.1002/14651858.CD013046.pub2

Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Syeda Huda Zehra Jaffri (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
The Journal of Women and Child Health (JoWaCH) adheres to the CC BY 4.0 license, which is a Creative Commons Attribution 4.0 International License. For comprehensive information, we kindly request that you refer to the full license legal code. JoWaCH employs a non-exclusive license agreement for the purpose of open-access publication. In the context of open access publishing, the authors maintain the copyright of their work while also granting the journal the rights to publish and distribute it, while retaining the primary academic use rights. This practice facilitates the optimal use and dissemination of the work, while also guaranteeing proper attribution to the original source. The handling of manuscript content shall be conducted with confidentiality, with the exception of cases involving review processes and investigations related to potential misconduct, plagiarism, and duplicate/redundant or overlapping publications, in accordance with the guidelines provided by the Committee on Publication Ethics (COPE) COPE Guidelines.
JoWaCH is prohibited from disseminating content derived from previously published scientific work without obtaining proper authorization. Obtaining permission from the copyright holder, who may be either the author(s) or the publisher, is necessary in cases where the copyright holder is the publisher, for any work you want to use.
While it is acceptable to use a small amount of a work, obtaining permission from the copyright owners is necessary for a significant extraction.
The use of unmodified or little modified tables, graphs, and artworks (whether they are the user's own work previously published elsewhere or created by another copyright holder) necessitates obtaining permission.
Tables, graphs, charts, and artworks that have been fully redesigned and rebuilt, and include proper reference of the source, do not need obtaining permission.
JoWaCH facilitates unrestricted access to journal material for readers, necessitating the imposition of membership fees. The journal operates on a self-sustaining financial model and does not rely on support from other sources. The procedure of publishing is contingent only upon the financial resources of the publisher. The readers have unrestricted access to the information on the journal website.