Βιταμίνη Ε, Τοκοφερόλη

There are several substances, natural or synthetic, that form the vitamin E complex. The most important component are the tocopherols, the α-tocopherol being the most active and widely distributed in nature. Beta, gamma and delta tocopherol are also natural. Tocotrienols are also vitamin E. Natural alpha-tocopherols are d-isomers. The dl form, less active, is synthetic.

The daily vitamin E requirements for a breastfeeding mother are 12 to 19 mg (28 IU) daily; and for an infant in the first year of life, 4 to 5 mg (6 to 8 IU). ^{(NIH 2016, Ares 2015, Hall 2010)}

No supplements are necessary if diet and nutritional status are adequate. Supplementation does not increase milk levels in well-nourished women, but does so in those with low nutritional status.

The concentration of vitamin E (α-tocopherol) is highest in colostrum (6.5 to 15 mg/L) ^{(Xue 2017, Melo 2017)} and drops to half/a third in transition milk and a third/a fifth in mature milk ^{(Xue 2017, Silva 2017, Jiang 2016, Lima 2014)}. The high concentration of α-tocopherol in colostrum causes breastfed newborns to reach adult plasma levels of vitamin E. (initially one third of them) in 4 to 6 days. ^{(Ostrea 1986)}

The first week’s milk of mothers of premature babies and of children over 4kg at birth has a higher content of α-tocopherol ^{(Grilo 2013, Gross 1985)}. Alpha tocopherol may be slightly decreased in mature milk after high-risk pregnancies ^{(Sámano 2017)}. Preterm infants with preterm breast milk had a higher plasma level of vitamin E than those fed with mature milk and both groups had a higher level than those fed artificial formula. ^{(Gross 1985)}

Breastmilk contains greater contcentration of vitamin E than cow's milk. In the first year of life, breastfed infants had better plasma vitamin E levels than non-breastfed infants. ^{(Martínez 1984)}

Maternal vitamin E supplementation increases the concentration of vitamin E in colostrum and transition milk ^{(Keikha 2021, Melo 2017, Pires 2016, Clemente 2015)}, but not in mature milk ^{(Pires 2016)} and no relationship has been found between diet and the concentration of α-tocopherol in breastmilk ^{(Jiang 2016)}, although higher levels of vitamin E in breast milk were associated with a higher intake of polyunsaturated fatty acids. ^{(da Mata 2020)}

Maternal vitamin E deficiency is not related to breastmilk levels ^{(da Silva 2016)}. The contribution of vitamins of the B complex and vitamins C and E to HIV+ mothers improves the weight gain of their infants. ^{(Villamor 2005)}

The topical application of vitamin E on the nipples of breastfeeding mothers over 6 days caused a significant increase in the plasma levels of vitamin E in the infants, who did not show adverse effects. ^{(Marx 1985)}