Breastfeeding A to Z

Vitamin D Supplementation

Currently, the American Academy of Pediatrics (AAP) has recommended routine Vitamin D supplements of 400 IU per day for breastfed infants from birth to avoid development of Vitamin D deficiency. (1)

Direct sun exposure is discouraged for your baby prior to 6 months of age and when baby is older sunscreen is recommended.  Because sunscreen limits the amount of Vitamin D that can be made in the skin, supplementing your baby is recommended. (1)(2)

Breastmilk contains small amounts of Vitamin D, but the majority of our Vitamin D comes from sun exposure. (2)

A deficiency of Vitamin D can cause rickets, but this is uncommon in breastfed infants.  Those at greatest risk of rickets are dark-skinned children living in situations where clothing or activity reduces skin exposure to the sun and mothers eating vegetarian diets that exclude meat, fish and dairy products (all food sources of Vitamin D).  If a child is adequately exposed to the sun (this is how Vitamin D is formed in the skin for our bodies use) and whose mother consumes adequate nutrients may not need routine vitamin D supplements (2)

By increasing Vitamin D in a mother’s diet, an increase is seen in Vitamin D available for a breastfeeding baby. (3)  Vitamin D levels can be inadequate in human milk in some situations especially in cold climates in the winter with little sunshine and for dark-skinned individuals.  There is some concern that Vitamin D deficiency in infants can sometimes be attributed to inadequate levels of Vitamin D during their mother’s pregnancy. (3)  If during pregnancy and breastfeeding women who are at risk for Vitamin D deficiency are not able to take in greater amounts via diet and/or supplements, it will probably be necessary to supplement normal breastfeeding infants. (3)

Discuss with your healthcare provider whether you want to supplement yourself or your baby to provide adequate Vitamin D based on your lifestyle.

References:

  1. Kleinman, RE, Greer, FR, Pediatric Nutrition, 7th edition, Elk Grove Village, IL, American Academy of Pediatrics, 2014, p 129
  2. Wambach, K, Riordan, J, Breastfeeding & Human Lactation, 5th edition, Burlington, MA, Jones & Bartlett Learning, 2016, p 134, 697.
  3. Lawrence, RA, Lawrence, RM, Breastfeeding: A Guide for the Medical Professional, 7th edition, Maryland Heights, MO, Elsevier Mosby, 2011, p 135.