Why is Vitamin D while breastfeeding so important?
Vitamin D is a group of compounds that our bodies need, for not only bone health but also for immune function.
Although vitamin D deficiency is most often associated with rickets, emerging research is starting to link vitamin D deficiency with a host of ailments. Some of are arthritis, diabetes, heart disease and even cancer.
If breast milk is the perfect food for newborns, why would it lack Vitamin D?
Vitamin D deficiency is the consequence of modern lifestyles.
Some of your vitamin D intake comes from foods – especially those that are fortified, such as milk – but there is not enough vitamin D in food alone to meet your daily needs.
Your body also synthesises its own vitamin D from exposure to sunlight (UVB).
The lack of sunlight exposure in modern life is often a cause for vitamin D insufficiency. In more traditional cultures, where mothers spend many hours each day outdoors, breastfed infants get adequate vitamin D from breastfeeding alone and maternal supplementation is unnecessary.
In the 21st century, because of the fear of skin cancer, regular use of sunscreen, and a more indoor lifestyle, our sun exposure has become more limited, making many adults vitamin D deficient.
The fact that breast milk is naturally low in vitamin D does not mean that you should not breastfeed your baby. Breast milk contains vitally important nutrition for babies.
To learn more about this, you can read BellyBelly’s article New Immune Cells Found In Breastmilk: Study.
Other causes for Vitamin D deficiency
Other factors can contribute to vitamin D deficiency – for example:
- Living at a high latitude, where there are fewer hours of sunlight and the sun is not as strong as it is at lower latitudes (the further from the equator, the less UVB is available)
- Living in areas of greater air pollution, which blocks some of the necessary UV rays
- Living in a culture where much of the skin is covered; this is especially true for women
- Skin pigmentation (the darker the skin, the longer you need to be in the sun).
These risk factors are true for children and babies too.
Other risk factors for babies are:
- Being exclusively breastfed infants of vitamin D deficient mothers
- Being born prematurely
- Being born in winter or early spring.
Given the fact that sunscreen isn’t recommended for babies younger than 6 months, the advice is to keep them out of the sun altogether. This means that a baby’s main source of vitamin D is completely absent.
Would exposing my breastfed baby to sunlight avoid vitamin D deficiency?
Because no one is sure how much UV exposure is appropriate for infants (or at what point damage begins), you need to weigh up the risks of sun exposure against the possible benefits.
If you plan to have your baby out in the sun, limit exposure to early morning or evening and avoid exposure when the sun is at its strongest.
The safest way to ensure adequate vitamin D in breastfed infants is by providing vitamin D supplementation.
Maternal versus infant Vitamin D supplementation
Research shows that maternal vitamin D supplementation increases infant vitamin D in a breastfed baby.
One study found that if a breastfeeding mother took vitamin D supplements of 2000-4000 IU daily, her baby’s vitamin D status improved. Other researchers found that maternal vitamin D supplementation of 2000 IU was as effective at maintaining a baby’s vitamin D status as giving the baby 400 IU per day directly.
In opposition to this, other research has found that 6400 IU per day are needed to maintain baby’s status through breast milk.
If you decide to take a vitamin D supplement yourself instead of giving one to your baby, be sure to take it every day. Vitamin D isn’t stored for long and the body needs regular exposure.
It is also important to make sure you are taking enough; 400 IU for a breastfeeding mother is probably not going to raise the vitamin D level in breast milk enough to be protective for her baby.
Will giving my baby Vitamin D affect breastfeeding?
There is no need to worry that infant vitamin D supplementation is somehow going to sabotage breastfeeding. The best way to combat the adverse health effects is through infant supplementation.
Exclusive breastfeeding can be maintained along with infant vitamin D supplementation (usually in the form of drops).
Do formula fed babies need Vitamin D supplementation?
Formula fed babies get vitamin D through their infant formula, which is fortified with enough to ensure adequate vitamin D intake.
A wide range of opinions exist for the best way to optimize the vitamin D status of breastfed babies:
- In the United States, the American Academy of Pediatrics recommends 400 IU per day of vitamin D for all breastfed babies, from birth
- In Australia, the recommendation is the same but some Australian sources advise infants have their vitamin D levels tested to make a determination as to whether or not the baby needs a supplement
- In Canada and the UK, it’s recommended that a mother be supplemented so her baby can get more vitamin D through breast milk.
Should pregnant women take Vitamin D supplements?
Researchers suggest that women should be tested early in pregnancy to establish their baseline vitamin D status and, if it’s not within the range of normal, the pregnant mother should start taking a vitamin D supplement.
The amount of supplementation would be determined, based on maternal blood levels.
It is possible to get too much vitamin D and toxic levels can cause damage to the unborn baby. Therefore, working closely with your healthcare provider is essential.
For more information, you can read BellyBelly’s article Vitamin D During Pregnancy – 5 FAQs Answered.
If you’re interested in a more in-depth exploration, the book New Insights into Vitamin D During Pregnancy, Lactation and Early Infancy is a great resource.
A fact sheet produced by the National Institutes of Health in the US is another great resource, especially if you’re interested in food sources of vitamin D as well as recommendations for different life stages.
- Centers for Disease Control and Prevention. (2009). Vitamin D supplementation.
- Creighton University. Vitamin D and the nursing mother. ScienceDaily, 6 June 2014.
- Kulie, T., Groff, A., Redmer, J., Hounshell, J., & Schrager, S. (2009). Vitamin D: an evidence-based review. J Am Board Fam Med, 22(6), 698-706.
- Merewood, A. (2013). Does my breastfed baby need extra vitamin D? J Hum Lact 29(1), 100-1.
- Munns, C., Zacharin, M. R., Rodda, C. P., Batch, J. A., Morley, R., Cranswick, N. E. & Cowell, C. T. (2006). Prevention and treatment of infant and childhood vitamin D deficiency in Australia and New Zealand: a consensus statement. Med J Australia, 185(5), 268.
- Wagner, C. L. (2011). Vitamin D: Recommendations during Pregnancy, Lactation and Early Infancy. Clinical Lactation, 2(1), 27-32.