At your first pediatric visit, the physician recommended a vitamin D supplement for your breastfed baby. But you thought breastmilk was a complete food - that it had exactly what your baby needed to be healthy. So what gives?
Vitamin D - which isn’t truly a vitamin but rather a ‘pre-hormone’ - is necessary not only for strong bones, but also as an essential building block for a strong immune system.
While some vitamin D can be had through our diets (fatty fish, especially salmon, herring, and tuna, contain vitamin D, as do many fortified foods such as cow’s milk), we synthesize most of the substance from exposure to sunlight. Most babies get what they need from spending time in the sun.
But, since diseases related to vitamin D deficiency have begun to rise, the American Academy of Pediatrics has recommended all breastfed babies be supplemented with 400IU of vitamin D each day. (Formula already has vitamin D added, so these babies don’t need the additional supplement.)
Vitamin D deficiency can lead to rickets - a disease where the bones soften and bend. Your baby is at higher risk of vitamin D deficiency if:
- you live at higher latitudes with fewer hours of sunlight each day
- you live in areas with high air pollution which filters much of the sunlight
- your baby has darker skin pigmentation
- you live in a culture where much of your baby’s skin is covered, by clothing or by sunscreen
- your baby spends most of his time indoors
- you are vitamin D deficient yourself, and your baby is exclusively breastfed
When a mom’s vitamin D status is normal during pregnancy and breastfeeding, her baby will get what he needs. Many women are, however, vitamin D deficient themselves. Interestingly, researchers have found when a breastfeeding mother supplements herself with 6400IU of vitamin D daily, her baby’s vitamin D status remains at a healthy level. Another group of researchers found that giving breastfeeding moms a high monthly dose of vitamin D was enough to maintain her vitamin D status as well as keeping her breastfed infant from deficiency. If you are hesitant about giving your baby a vitamin D supplement, you might consider them for yourself instead. You can have your own vitamin D levels tested to see what your status is, and proceed accordingly.
It’s important to keep in mind that breastmilk isn’t deficient - the problem is simply that humans get most of their vitamin D from sunlight, and our modern lives limit this exposure. The vitamin D supplements for your baby are just a few drops of liquid, and they won’t interfere with breastfeeding or with your milk supply. The drops are sometimes part of a combination vitamin supplement, but vitamin D only supplements are available (ask your doctor or pharmacist for additional information).
Hollis BW, Wagner CL, Howard CR, Ebeling M, Shary JR, Smith PG, Taylor SN, Morella K, Lawrence RA, & Hulsey TC. (2015). Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial. Pediatrics 136(4). 625-34.
Wheeler BJ, Taylor BJ, Herbison P, Haszard JJ, Mikhail A, Jones S, Harper MJ, & Houghton LA. (2016). High-Dose Monthly Maternal Cholecalciferol Supplementation during Breastfeeding Affects Maternal and Infant Vitamin D Status at 5 Months Postpartum: A Randomized Controlled Trial. J Nutr. [Epub ahead of print].