Last update Dec. 2, 2022

Vitamin C

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Ascorbic acid and its calcium and sodium salts have the activity of vitamin C, an essential water-soluble vitamin, necessary for the normal functioning of the body. It is not produced or accumulated in the body (it is eliminated by the kidney) and must be ingested with the diet; it is very abundant in fruits and vegetables. It has antioxidant properties, improves iron absorption, keeps tissues, collagen, cartilage, bones, teeth and gums healthy, and is necessary for wound healing and immune system functioning. (MedlinePlus 2019, Castro 2019)

Breast milk contains controlled levels between 50 and 100 mg/L according to the amount of vitamin C in the diet (Sauberan 2019, Tawfeek 2002). Levels are slightly higher in colostrum (Ahmed 2011) and in the milk of premature mothers (Udipi 1985) and decrease slightly throughout lactation. (Karra 1986)

Breast milk from malnourished mothers has levels below 50 mg/L that improve with supplements of 100 to 200 mg/day (Daneel 2005, Bates 1983). In well-nourished mothers, supplements hardly modify vitamin C levels. (Sauberan 2019, Daneel 2005, Thomas 1980 and 1979, Munks 1947)

The relationship between vitamin C intake and breast milk levels is not well clarified (Keikha 2021). Excessive intakes of vitamin C (even above 1,000 mg per day) do little to increase the levels in breast milk. (Byerley 1985, Anderson 1985, Sneed 1981)

There are lower levels of vitamin C in the milk of women who smoke or have diabetes. (Heinz 1987)

The daily needs of the nursing mother are 100 to 120 mg per day (NIH 2021, MedlinePlus 2019, Ares 2015, Hall 2010). Needs in children younger than 6 months are 40 mg per day. (NIH 2021, MedlinePlus 2019)

Except in malnourished mothers and/or smokers, with a varied and balanced diet, no vitamin C supplements are needed. (Ares 2015)

The freezing (Buss 2001, Bank 1985) and pasteurization (Castro 2019) of breast milk variably decrease vitamin C levels, which can result in low plasma levels of vitamin C in premature infants fed with pasteurized bank milk who do not receive vitamin C supplements. (Castro 2021 and 2019, Heinonen 1986)

Increased concentration of vitamin C in breast milk could prevent the risk of atopy in infants. (Hoppu 2005)

The use of excessive amounts of vitamin C intravenously should be avoided in mothers with renal impairment, a history of kidney stones, G6PD deficiency or paroxysmal nocturnal hematuria, as well as in mothers of infants with kidney problems or G6PD deficiency. (Khoshnam 2019, Quinn 2017, Huang 2014, Rees 1993)

List of essential medicines WHO: compatible with breastfeeding. (WHO 2002).

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Vitamin C is also known as


Vitamin C in other languages or writings:

Group

Vitamin C belongs to this group or family:

Tradenames

Main tradenames from several countries containing Vitamin C in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 70 - 90 %
Molecular weight 176 daltons
Protein Binding 25 %
pKa 4.36 -
Tmax 2 - 3 hours
384 hours

References

  1. Keikha M, Shayan-Moghadam R, Bahreynian M, Kelishadi R. Nutritional supplements and mother's milk composition: a systematic review of interventional studies. Int Breastfeed J. 2021 Jan 4;16(1):1. Abstract Full text (link to original source)
  2. Castro M, Pitino MA, Bando N, Aufreiter S, Stone D, O'Connor DL, Unger S. Term Infants Fed Exclusively With Donor Milk May Require Vitamin C Supplementation. JPEN J Parenter Enteral Nutr. 2021 Jan 12. Abstract
  3. NIH. Vitamin C. Fact Sheet for Health Professionals. 2021 Full text (link to original source) Full text (in our servers)
  4. Castro M, Pitino M, Bando N, Aufreiter S, O'Connor D, Unger S Infants exclusively fed human donor milk require supplementation with vitamin C. Pediatric Academic Societies Meeting (PASM) 2019 Full text (link to original source) Full text (in our servers)
  5. Sauberan JB. High-Dose Vitamins. Breastfeed Med. 2019 Apr 30. Abstract
  6. Khoshnam-Rad N, Khalili H. Safety of vitamin C in sepsis: a neglected topic. Curr Opin Crit Care. 2019 Aug;25(4):329-333. Abstract
  7. MedlinePlus. Vitamin C Trusted Health information for you. 2019 Full text (link to original source) Full text (in our servers)
  8. MedlinePlus. Vitamina C. Información de salud para usted. 2019 Full text (link to original source) Full text (in our servers)
  9. Quinn J, Gerber B, Fouche R, Kenyon K, Blom Z, Muthukanagaraj P. Effect of High-Dose Vitamin C Infusion in a Glucose-6-Phosphate Dehydrogenase-Deficient Patient. Case Rep Med. 2017;2017:5202606. Abstract Full text (link to original source)
  10. Ares Segura S, Arena Ansótegui J, Díaz-Gómez NM; en representación del Comité de Lactancia Materna de la Asociación Española de Pediatría. La importancia de la nutrición materna durante la lactancia, ¿necesitan las madres lactantes suplementos nutricionales? [The importance of maternal nutrition during breastfeeding: Do breastfeeding mothers need nutritional supplements?] An Pediatr (Barc). 2015 Abstract Full text (link to original source) Full text (in our servers)
  11. Huang YC, Chang TK, Fu YC, Jan SL. C for colored urine: acute hemolysis induced by high-dose ascorbic acid. Clin Toxicol (Phila). 2014 Nov;52(9):984. Abstract
  12. Hall Moran V, Lowe N, Crossland N, Berti C, Cetin I, Hermoso M, Koletzko B, Dykes F. Nutritional requirements during lactation. Towards European alignment of reference values: the EURRECA network. Matern Child Nutr. 2010 Oct;6 Suppl 2:39-54. Abstract Full text (link to original source) Full text (in our servers)
  13. Daneel-Otterbech S, Davidsson L, Hurrell R. Ascorbic acid supplementation and regular consumption of fresh orange juice increase the ascorbic acid content of human milk: studies in European and African lactating women. Am J Clin Nutr. 2005 May;81(5):1088-93. Abstract Full text (link to original source) Full text (in our servers)
  14. Hoppu U, Rinne M, Salo-Väänänen P, Lampi AM, Piironen V, Isolauri E. Vitamin C in breast milk may reduce the risk of atopy in the infant. Eur J Clin Nutr. 2005 Abstract Full text (in our servers)
  15. Ahmed L Jr, Islam S, Khan N, Nahid S. Vitamin C content in human milk (colostrum, transitional and mature) and serum of a sample of bangladeshi mothers. Malays J Nutr. 2004 Mar;10(1):1-4. Epub 2004 Mar 15. Abstract
  16. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  17. Tawfeek HI, Muhyaddin OM, al-Sanwi HI, al-Baety N. Effect of maternal dietary vitamin C intake on the level of vitamin C in breastmilk among nursing mothers in Baghdad, Iraq. Food Nutr Bull. 2002 Abstract
  18. Buss IH, McGill F, Darlow BA, Winterbourn CC. Vitamin C is reduced in human milk after storage. Acta Paediatr. 2001 Jul;90(7):813-5. Abstract
  19. Rees DC, Kelsey H, Richards JD. Acute haemolysis induced by high dose ascorbic acid in glucose-6-phosphate dehydrogenase deficiency. BMJ. 1993 Mar 27;306(6881):841-2. No abstract available. Abstract
  20. Heinz-Erian P, Achmüller M, Berger H, Brabéc W, Nirk S, Rufer R. [Vitamin C concentrations in maternal plasma, amniotic fluid, umbilical cord blood, the plasma of newborn infants, colostrum and transitory and mature breast milk]. Padiatr Padol. 1987;22(2):163-78. German. Abstract
  21. Karra MV, Udipi SA, Kirksey A, Roepke JL. Changes in specific nutrients in breast milk during extended lactation. Am J Clin Nutr. 1986 Apr;43(4):495-503. Abstract
  22. Heinonen K, Mononen I, Mononen T, Parviainen M, Penttilä I, Launiala K. Plasma vitamin C levels are low in premature infants fed human milk. Am J Clin Nutr. 1986 Jun;43(6):923-4. Abstract
  23. Bank MR, Kirksey A, West K, Giacoia G. Effect of storage time and temperature on folacin and vitamin C levels in term and preterm human milk. Am J Clin Nutr. 1985 Feb;41(2):235-42. Abstract
  24. Byerley LO, Kirksey A. Effects of different levels of vitamin C intake on the vitamin C concentration in human milk and the vitamin C intakes of breast-fed infants. Am J Clin Nutr. 1985 Abstract Full text (in our servers)
  25. Udipi SA, Kirksey A, West K, Giacoia G. Vitamin B6, vitamin C and folacin levels in milk from mothers of term and preterm infants during the neonatal period. Am J Clin Nutr. 1985 Sep;42(3):522-30. Abstract
  26. Anderson DM, Pittard WB 3rd. Vitamin E and C concentrations in human milk with maternal megadosing: a case report. J Am Diet Assoc. 1985 Abstract
  27. Bates CJ, Prentice AM, Prentice A, Lamb WH, Whitehead RG. The effect of vitamin C supplementation on lactating women in Keneba, a West African rural community. Int J Vitam Nutr Res. 1983;53(1):68-76. Abstract
  28. Sneed SM, Zane C, Thomas MR. The effects of ascorbic acid, vitamin B6, vitamin B12, and folic acid supplementation on the breast milk and maternal nutritional status of low socioeconomic lactating women. Am J Clin Nutr. 1981 Jul;34(7):1338-46. Abstract
  29. Thomas MR, Sneed SM, Wei C, Nail PA, Wilson M, Sprinkle EE 3rd. The effects of vitamin C, vitamin B6, vitamin B12, folic acid, riboflavin, and thiamin on the breast milk and maternal status of well-nourished women at 6 months postpartum. Am J Clin Nutr. 1980 Abstract
  30. Thomas MR, Kawamoto J, Sneed SM, Eakin R. The effects of vitamin C, vitamin B6, and vitamin B12 supplementation on the breast milk and maternal status of well-nourished women. Am J Clin Nutr. 1979 Abstract Full text (in our servers)
  31. MUNKS B, KAUCHER M, et al. Metabolism of women during the reproductive cycle; vitamin C in diets, breast milk, blood and urine of nursing mothers. J Nutr. 1947 Abstract Full text (in our servers)

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