Vitamin E
What is vitamin E and what function does it play in the body?
Vitamin E is a fat-soluble vitamin, which means that its absorption from the intestine depends on fat digestion. The vitamin serves as an antioxidant; it protects the body from the damaging effects of excess oxygen and other substances acting like oxygen, called free radicals. These substances can damage cells by causing changes in the outer fat covering of cells.
Do other food substances in the diet affect the need for vitamin E?
The need for vitamin E is related to the amount and kind of fat in the diet. Dietary fat will affect the type of fat in the covering of cells in the body. Unsaturated fats (as opposed to saturated fats) in particular will change the biochemistry of cells. The more unsaturated fat in the diet, the greater the need for vitamin E.
Can I start my baby on vitamin E to improve his growth?
No. Supplemental vitamin E does not result in improved growth.
A friend told me that vitamin E is one of those "safe" vitamins. You can take a lot without getting into trouble. Is that correct?
Large doses of vitamin E taken by mouth are well tolerated by adults. Newborn infants are more likely to have side effects. Bleeding due to suppression of certain clotting factors may result from taking large amounts of the vitamin (much greater than amounts found in breast milk or infant formulas). Serious side effects have been reported in association with large amounts of vitamin E given by injection.
Does my diet during pregnancy have any effect on the amount of vitamin E my baby will have at birth?
Newborn infants have blood levels of vitamin E that are less than half those of their mothers. Under most conditions, a mother's diet during pregnancy has only a small effect on the amount of vitamin E the baby receives. Likewise, vitamin E given to the mother during pregnancy has little effect on the amount that gets across the placenta into the baby.
Is breast milk as good as formulas are in supplying adequate amounts of vitamin E for the baby?
It's better! Breast milk contains the right amount of vitamin E and fat for infants. Cow's milk is a relatively poor source of vitamin E. Consequently, commercial infant formulas are fortified with vitamin E. Breastfed infants have sufficient vitamin E sooner and have higher blood levels of the vitamin than do formula-fed infants. This is because the vitamin E in breast milk is in a more potent form with better absorption from the infant's intestine.
Do infant formulas on the market differ much in the vitamin E they contain?
There are small differences in the amount of vitamin E among formulas. However, all formulas manufactured for infants provide more vitamin E than required.
Does the nursing mother's diet have any effect on the amount of vitamin E in her breast milk?
Adequate amounts of vitamin E are present in breast milk over a wide range of diets taken by the mother. However, the mother's diet may have an effect on the need for vitamin E by the baby. Mothers eating diets high in unsaturated fats produce milk higher in unsaturated fats. This increases the baby's need for vitamin E.
Which babies are at risk for deficiency of vitamin E?
There are two major groups of infants who are at risk for vitamin E deficiency. One group is premature infants who have low body stores of the vitamin at birth, have poor absorption of fat and fat-soluble vitamins, including vitamin E, and have high requirements because of rapid growth. The other group of infants at risk for vitamin E deficiency are infants with problems absorbing fats, such as those with cystic fibrosis. These infants need additional fat-soluble vitamins, including vitamin E.
I've heard that vitamin E has something to do with longevity. Is that true?
Vitamin E has been advocated for everything from treating baldness to increasing life span. There is no truth to these claims.
They tell me that vitamin E is very important for reproduction. Can I be sure that my baby gets enough of it in infancy?
When vitamin E was first discovered in 1922, it was found to be essential for normal reproduction in rats. No such role for vitamin E in humans has been documented. You can be sure your baby gets enough vitamin E by breastfeeding him or feeding one of the commercial infant formulas, all of which are fortified with vitamin E.
I've heard that when babies drink formulas, they don't receive so much vitamin E. Is that correct?
Generally, all currently marketed infant formulas designed for normal infants are made to provide adequate amounts of vitamin E, as well as the right amount of vitamin E in relation to unsaturated fats.
I've heard that you can get some nerve disease when you don't have enough vitamin E. Is that correct?
As a general rule, no. Very rarely, however, children are born with disease causing very poor absorption of fat in the gut (severe fat malabsorption) and very low levels of fat in the blood. These children are unable to absorb vitamin E and may have a nerve disease that begins well after infancy and becomes worse as the child grows older.
What about anemia?
In premature infants, anemia (low red blood cell count) can be due to vitamin E deficiency. Infants who are deficient in vitamin E may develop anemia due to increased destruction of red blood cells. This used to be much more common before infant formulas were fortified with vitamin E. Current formulas provide more vitamin E in relation to fat and help to prevent problems in the red blood cells.
I've heard about babies getting overloaded with vitamin E. They have even reported death in babies. Is that true?
The overload associated with vitamin E administration has followed very large doses of the vitamin usually given by injection. The very high levels of the vitamin resulted in lung, liver, and kidney failure and, in several cases, death. The form of vitamin E (given intravenously) that was associated with these findings has been removed from the market.
I've heard of vitamin E being called an antioxidant. I thought oxygen was important for us.
Oxygen is important for us. However, breakdown products of oxygen produced in the body can be toxic and must be disposed of in some way. Vitamin E acts as an antioxidant by substituting for oxygen in some of these reactions.
I like taking vitamin E pills (they give me energy) but I am breastfeeding my baby. Is that good for my baby?
Small doses of extra vitamin E taken as a vitamin pill will have no negative effect on the baby. There is no real information that vitamin E gives people more energy; it may be a placebo (psychological effect).
They tell me that there are several kinds of vitamin E and that they all differ. Is that correct?
There are actually eight naturally occurring vitamin E compounds with antioxidant activity. One form of vitamin E, alpha-tocopherol (alpha vitamin E), makes up the vast majority of vitamin E in the human body. The only other compounds of importance for infants are beta-tocopherol and gamma-tocopherol, but they are much less active forms of the vitamin.
I want to make sure my baby has enough vitamins. How much vitamin E should I give to my baby?
The normal newborn baby will receive adequate amounts of vitamin E in breast milk or standard infant formula. Only high-risk babies, such as those who are premature or those with problems with fat absorption, need additional vitamin E.
Do the usual multivitamins contain vitamin E? I want to make sure my baby gets vitamin E.
The standard multivitamins on the market for infants contain five international units of vitamin E per dose. This is approximately the amount the normal baby receives per day when he is fed a regular infant formula.
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