Vitamin D Supplements & Breastfeeding

Today, Carole Arsenault of Newborn Nurses shares information on vitamin D supplements for breastfed babies:

A lot of breastfeeding moms ask me whether their baby needs a vitamin D supplement. The answer is yes; the American Academy of Pediatrics (AAP) recommends that all children receive 400 IU a day of vitamin D, beginning within the first few days of life. This is double the previous 2003 recommendation of 200 IU per day. The change follows data from new clinical trials, and the historical precedence of safely giving 400 IU per day to the pediatric population.
Importantly, clinical data show that 400 IU of vitamin D a day will prevent and treat rickets. (Adequate vitamin D through childhood also may help reduce the risk of osteoporosis, and in adults vitamin D may help prevent infections, autoimmune diseases, cancer, and diabetes.) Rickets continues to be reported in the United States in infants and adolescents and is preventable with adequate vitamin D, but dietary sources of vitamin D are limited and it is difficult to determine a safe amount of sunlight exposure to synthesize vitamin D per individual.

The greatest risk for rickets is in exclusively breastfed infants who do not receive vitamin D supplements.

The AAP report recommends:

"Breastfeeding is the best source of nutrition for infants. However, because of vitamin D deficiencies in the maternal diet, which affect the vitamin D in mother’s milk, it is important that breastfed infants receive supplements of vitamin D…Until it is determined what the vitamin D requirements of the lactating mother-infant dyad are, we must ensure that the breastfeeding infant receives an adequate supply of vitamin D through a supplement of 400 IU per day." - Carol Wagner, MD, member of the AAP section on Breastfeeding Executive Committee

Specifically, the new recommendations suggest that:

"Breastfed and partially breastfed infants should be supplemented with 400 IU a day of vitamin D, beginning in the first few days of life.

All non-breastfed infants, as well as older children, who are consuming less than one quart per day of vitamin D-fortified formula or milk, should receive a vitamin D supplement of 400 IU a day.

Adolescents who do not obtain 400 IU of vitamin D per day through foods should receive a supplement containing that amount.

Children with increased risk of vitamin D deficiencies, such as those taking certain medications, may need higher doses of vitamin D."

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