In recent years, amongst health professionals and scientists, there has been growing interest in vitamin D.
This is mainly due to increasing rates of rickets in developed countries.
Vitamin D’s role in bone metabolism has been known for a long time.
More recently, it has been discovered that vitamin D might have many other functions in the human body, and could play an important role in the prevention of many chronic diseases.
Because vitamin D is so important, it’s essential we get enough of it right from the time we are born.
So, are any particular babies at risk of vitamin D deficiency? Are breastfed babies at risk? And if so, what should be done about it?
Here are 7 facts you need to know about vitamin D and the breastfed baby.
#1: Breastmilk Is Not ‘Deficient’ In Vitamin D
Much of the literature written about vitamin D and babies will make comments about breastmilk being deficient in vitamin D.
However, it’s not a fluke that breastmilk is the way it is. It’s the biologically normal way to feed babies, and so if there is ‘a lot’ or ‘a little’ of something in breastmilk, there are good reasons for that.
Breastmilk is not deficient in vitamin D. It’s true that levels of vitamin D are very low in breastmilk, but it’s not a fault of nature; there are physiological reasons for it.
So why does breastmilk have very low levels of vitamin D?
#2: We Are Designed To Get Vitamin D From Sun Exposure
When looking more deeply into why breastmilk has very little vitamin D, we discover we’re meant to get vitamin D from sun exposure rather than from our diet. If we get sufficient vitamin D from sun exposure, then there is no need for breastmilk to have much of it at all.
However, in countries like Australia, there are high rates of skin cancer. For that reason, many of us have certainly taken notice of the public health messages about being ‘sun-smart'. This, combined with our technologically driven lifestyles, means many of us get less sun exposure than previous generations did. While less sun exposure is important in reducing the risk of skin cancer, it increases our risk of vitamin D deficiency.
But how much sun exposure is enough for us to get enough vitamin D?
#3: Safe Sun Exposure Time For Children Is Unknown
Regular sun exposure can help prevent vitamin D deficiency, but the safe exposure time for children is unknown. The benefits of sun exposure need to be weighed up against the risks. If you have your baby out in the sun, perhaps limited exposure, in the early morning or evening might be best. The length of time needed for adequate vitamin D has not been accurately quantified and would vary according to the time of day and where you live.
Sun Smart Australia provides information to help you determine how much sun is enough. You can visit their site here.
#4: Not All Babies Are At Risk Of Vitamin D Deficiency
Not all babies are at risk of vitamin D deficiency. Breastfed babies who are particularly at risk are those:
- Who are dark-skinned
- Who receive too little sunlight (e.g. by living at higher latitudes)
- Whose mother is vitamin D deficient. During pregnancy, a foetus lays down stores of vitamin D. The baby then uses this store during the first few months of life. If a baby is born to a vitamin D deficient mother, then his stores will be deficient at birth. Women are often tested early in pregnancy to assess their vitamin D status and begin supplementation if necessary
#5: The Ideal Vitamin D Level Is Unknown
There is controversy over what level of vitamin D is sufficient.
The Institute of Medicine suggests vitamin D sufficiency is a blood concentration of at least 50 nmol/L. The Endocrine Society suggests vitamin D sufficiency is a blood concentration of at least 75 nmol/L.
#6: Different Countries Have Different Recommendations
Depending on where you live in the world, the recommendation regarding vitamin D supplementation varies.
In the United States, for example, the American Academy of Pediatrics recommends 400 IU per day of vitamin D for all breastfed babies from birth.
In Australia, the recommendation to use vitamin D supplements of 400 IU is limited to ‘at risk’ breastfed babies such as those born to dark-skinned and veiled women.
#7: Supplementing Breastfeeding Mothers Can Improve Their Babies’ Vitamin D Levels
Research shows that supplementing breastfeeding mothers can improve their babies’ vitamin D levels. If a breastfeeding mother takes vitamin D supplementation of 6400 IU/day it will supply her breastmilk with adequate vitamin D to satisfy her breastfed baby’s requirement. This offers an alternative strategy to giving a supplement directly to the baby.
Breastmilk cannot be expected to supply babies with their vitamin D needs, because human beings are meant to make vitamin D from sun exposure. However, because we have reduced sun exposure, due to lifestyle, or to minimise skin cancer risk, those at risk of vitamin D deficiency require supplementation.