Ergocalciferol Pregnancy and Breastfeeding Warnings
Ergocalciferol Pregnancy Warnings
Ergocalciferol (vitamin D2) has been assigned to pregnancy category C. When used within the recommended daily allowance for pregnant women, ergocalciferol is considered to be safe. The recommended daily allowance of vitamin D in pregnant women is 400 to 600 intl units. High doses of other vitamin D analogs have been shown to be teratogenic, resulting in external and skeletal abnormalities. Ergocalciferol should only be used during pregnancy when benefit outweighs the risk.
Supplementation of vitamin D during the third trimester with vitamin D2 or vitamin D3 has been studied. Dosages of 1000 intl units per day given daily during the third trimester did not result in any adverse fetal outcome. Neonatal calcium homeostasis was affected, resulting in significantly higher concentrations of calcium, 25-OH vitamin D3, and 1,25-(OH)2 vitamin D3. Earlier literature expressed concerns over the development of supravalvular aortic stenosis, craniofacial abnormalities, and dental abnormalities in infants and children with idiopathic hypercalcemia. Whether or not prenatal factors predisposed these children to the development of hypercalcemia is not known. Fifteen hypoparathyroid women receiving 50,000 to 250,000 Intl units of vitamin D2 experienced 27 uneventful births. No cardiovascular or craniofacial abnormalities were reported.
Ergocalciferol Breastfeeding Warnings
The American RDA for vitamin D in the lactating woman is 400 to 600 intl units. Vitamin D supplements may be necessary if maternal vitamin D nutrition is insufficient. The American Academy of Pediatrics considers ergocalciferol or vitamin D2 to be compatible with breast-feeding. If the mother is receiving pharmacological doses, serum calcium levels in the breast-fed infant should be monitored.
References for pregnancy information
- Rowe RD, Cooke RE "Vitamin D and craniofacial and dental anomalies of supravalvular stenosis." Pediatrics 43 (1969): 1-2
- Goodenday LS, Gordon GS "No risk from vitamin D in pregnancy." Ann Intern Med 75 (1971): 807-8
- Mallet E, Gugi B, Brunelle P, Henocq A, Basuyau JP, Lemeur H "Vitamin D supplementation in pregnancy: a controlled trial of two methods." Obstet Gynecol 68 (1986): 300-4
- Taussig HB "Possible injury to the cardiovascular system from vitamin D." Ann Intern Med 65 (1966): 1195-200
- Lester GE "Cholecalciferol and placental calcium transport." Fed Proc 45 (1986): 2524-7
- Delvin EE, Salle BL, Glorieux FH, Adeleine P, David LS "Vitamin D supplementation during pregnancy: effect on neonatal calcium homeostasis." J Pediatr 109 (1986): 328-34
References for breastfeeding information
- Committee on Drugs, 1992 to 1993 "The transfer of drugs and other chemicals into human milk." Pediatrics 93 (1994): 137-50
- American Academy of Pediatrics Committee on Nutrition "Vitamin and mineral supplement needs in normal children in the United States." Pediatrics 66 (1980): 1015-21
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