Do you give your breastfed baby vitamin drops?

[haloflo]

Specifically vitamin D? My friend is a nutrition student and said that its recommended to give breastfed babies vitamin D drops. I asked the HV who said only sick or babies who don't eat well need them. Who is right? From googling it looks like the NHS line is to give them. If its so important then why has no one told me this until now then?!

DD is 10mo and a picture of health.

Well said Mich :) Rickets still exist in UK do D is really important. Also iron is really important, in the states we do standard bloods on babies to make sure they are not iron deficient, iron can deplete by 4 months! And iron deficiency can cause major, major issues in brain and learning development! NAR4 ask yourself why you were taking pregnacare (who else took pregnacare or similar when pregnant) perhaps because the vitamins supported your pregnancy. Same company makes WellKid, which supports your baby with all the support for healthy growth she needs. So ladies why not offer similar support to your baby as you have done for yourself?

Sorry meant well said tiktok and Mich do some research on UK vitamin D deficiencies and rickets

Don't see many children here with rickets do you? don't need to look at research I know what it is, I have a degree in biochemistry and genetics. I have a brain I'm not just a mum. By all means look at research if you like. Remember theories can change. Look at chocolate, can be good for you on one hand and then bad on another. Depends on the time of year or which company is sponsoring the research. My point is, make up your own mind, don't worry needlessly and bring your child up as you see fit with a healthy diet and lots of love. There are so many confusing messages. Trust yourself.

i thought they said they are seeing more and more cases of rickets now, esp in families from ethnic backgrounds with darker skin tone? i heard something on the radio about it.

that said i have never given them to mine and 2 of mine are the age of recomendation for giving htme but we eat healthily and are always outside, the school run is at least 2 hrs a day for a start and they play out all the time.

Probably coz kids don't play out like we did when we were young. If I took note of every bit of research I wouldn't leave my house, eat or whatever. Use the research to make an informed choice. Don't use it to beat yourself up about. Life is too short.

i think its a combination of not playing out and using high factor sun screen, plus the fact that in the uk we have low levels of sun light anway.

i am certainly not beating myself up, my kids are happy and healthy and we have made an informed decision :)

Good for you 5madthings. [busmile]

Mich, you say "Use the research to make an informed choice"....absolutely. We look at the research (which shows justified concern about vit d deficiency) instead of just thinking 'you don't see many kids with rickets about' and concluding that all is well. Which is what you also said - and weirdly, for someone with a science background.

To repeat: guidance in the UK, based on research, is that vit d supps are a good idea for all infants and children.

I don't appreciate BeverleyHills's repeated mention of a brand name, though.

Apologies tiktok, glad pretty much everyone is agreed on Vit D, however iron is equally important and the only reason I mention the brand name is because it's the only one I've found here to cover all the bases including iron. If there's another pls tell me. Interesting though that no one "doesn't appreciate it" when ladies mention pregnacare

Beverley, it's because mumsnet has been used in the past as a vehicle for salespeople/marketeers to promote their products - repeated mentions by the same person of a product gives the impression it is happening again. It's an impression - not saying at all that you are doing this.

No, iron is not equally important - at least not at 6 mths. At least there is no evidence that it is. Concerns about iron and health effects of deficiencies are much rarer and occur in older toddlers anyway.

BeverlyHills It concerns me when terms like 'deficient'/'low' are used in relation to breastmilk because it is the biological norm against which everything else is measured. It is what it is and it has what it has because it is meant to be the sole source of calories and nutrition for the first 6 months of life only. The fact that after this point a baby's natural stores of key nutrients are run down and need replaced are not in dispute by anyone on here - but we evolved to replace and enhance these from this point onwards through our diet (except Vit D), not through artificial supplements, regardless of who makes these. Am a bit concerned about your blatant 'marketing speak' too, BH...

It is worth bearing in mind that it is entirely possible to have too much of a good thing and excessive iron supplementation carries it's own health risks too. Gabrielle Palmer has written about issues around iron here on p.40 (whole thing is an interesting discussion around complementary feeding).
www.ibfan.org/art/IBFAN_CF_FINAL_document.pdf On a personal level, I opted not to supplement my preterm bf baby after discussion with my GP but we made sure he was given naturally iron rich foods in his diet at 6 months onwards.

As far as the issues around vitamin D are concerned, I can assure you that living in the corner of the UK with the worst daylight quality in the country, there is an awareness of the problems of deficiency and it is something I have thought about in relation to my own children. It is my understanding that similiar issues in Scandinavia have been avoided because of the high levels of oily fish in their diet which we in the UK (and particularly here in Scotland)do not consume in nearly enough quantities.

However, I don't find having been told by my HV the other day to give a particular branded sweeping multivitamin supplement that contains Vit D is a satisfactory solution. I would rather give a single supplement if that was the road I was going to go down.

Oh dear, so very, very mis informed :( this is really important and it's really a shame no one is getting this, and so little info in the UK, iron deficiency can cause two major problems in EBF babies as young as 4 months, this is real and I am just trying to help not wanting to offend anyone. Reason being I know an EBF baby with mental issues caused by iron deficiencies and don't want this to happen to anyone else, if I can persuade only one person to take this seriously for the sake of their baby then I'll feel I've helped at least a little. So let me try and explain:
Iron deficiency anemia (small, pale red blood cells) can cause
slowed or depressed cognitive and behavioral development. Iron is critical for brain development and there is new research that iron status, starting in infancy, is essential for later cognitive performance. Think of ?cognitive performance? as seeing well, reasoning, remembering, and interacting with others. So this stuff matters.
Whilst I'd rather not send a message to you EBF moms that your milk isn't enough (ie your baby may need a supplement of iron in addition to vitamin D) the research is compelling and actually quite obvious. I should spread the word that we need to protect babies from deficiency of iron. So some actual facts and explanations:
Iron: Iron is important not only for building strong blood (seriously, I mean this) but also allowing a productive, smart, well-connected brain to form. It needs to be around in ample (but not too much) supply.
Babies & Toddlers at highest risk for complications include EBF babies from 4 months of age without iron supplements. Why: After 4 months of age, the stores of iron are used up in baby and human breastmilk contains very little iron. If a baby is weaned to foods that don?t include iron-fortified cereals or iron-rich foods, they are at higher risk. And as I want to EBF I have chosen to supplement with vitamins including iron. Anyone else who is EBF really needs to know this.
The AAP Recommendations:
Newborns: Term, healthy infants have sufficient iron for the first 4 months of life. Because human breast milk contains very little iron, breastfed infants should be supplemented with 1 mg/kg per day of oral iron from 4 months of age until iron-rich foods (such as iron-fortified cereals) are introduced. Please for the sake of your babies consider this. It can only do good. I really don't want to upset anyone only to help. I hear the comments that too much research can drive you crazy, but this is hugely important.

BH, the AAP has been criticised internationally for its links with formula manufacturers, so I would not take their recommendations as gospel.

Advice and guidance on supplementation does differ from country to country.

This is because opinions differ, even among experts, even among experts who are reading the evidence. No one has a monopoly on 'truth'.

Of course iron is important, but in the UK, there is no evidence that iron deficiency is a problem in EBF babies - from the age of about 6 mths it is appropriate that babies are introduced to solid food, including foods which contain iron, but there is no rush. Iron deficiency is not a problem in the UK among younger babies. There have been occasional instances in the UK of iron deficiency in older babies/toddlers who are not eating the 'right' foods. This is rare, and in this country it is not considered necessary for oral supps of iron to be routinely recommended. This is an evidence-based recommendation.

Not to throw a hand grenade into this conversation but.....

Isn't it more common in the US for immediate cord cutting/clamping to be performed rather than the more normal waiting for the cord to stop pulsing and the placental/cord blood to be infused into the baby. That gives the baby approx 1/3rd more blood and means they have much larger iron stores.

Also, iron-fortified cereals aren't a good source of bio-available iron as it is a)non-haem iron and b) only about 5% of the iron is absorbed by the baby compared to approx 50% of iron in breastmilk (iron in BM is bound to lactoferrin molecules and isn't available for microbes such as viruses and bacteria to use whereas it is in cereals).

Plus to be a pedant (sorry all) iron isn't a vitamin, it's a mineral so you need a vitamin and mineral supplement not just a vitamin supplement.

:( Well I tried, OK tiktok the UK is immune it's only a problem in the states. Seriously, all the HV's and GP's I've met here seem to be absolutely clueless. When I was pregnant I even had a GP here prescribe me an antibiotic, and when I called my OB he was furious and showed me the info that it should never be prescribed to a pregnant woman. As for the AAP, this is not them pushing formula, which I would never consider anyway. It's a fact, but don't ask your HV or GP ask your paedatrician: At 4 months your baby's store of iron has depleted and your breastmilk is not producing enough for him (however well the little iron you are providing him is absorbed it is simply too little) so at 4 months you need to supplement with the suggested dosage of iron or wean (and I ain't weaning) Anyone, in whatever country tells you different are ignorant, any good paedatrician will back this up. Anyway, I've tried my best, upto to you gals, but I bet most of you took pregnancy vitamins and many of you take breastfeeding vitamins. Feeling homesick, it's a strange attitude you have here, why take the chance? Why not do the best for your kid, it's like chicken soup, it can't do any harm, just stick to the right dose. And instead of arguing with facts as I say ask a paedatrician who will definitely back me up. And that's all from me, sorry if I've upset any of you :(

I am sorry Beverly I just don't understand this - if BM doesn't contain enough iron to get a baby to 4m without the baby having 'depleted' iron stores and as we know babies aren't ready for solids until 17w at the earliest - how did early man (or pre-industrialised societies that lack the ability to make iron drops) cope?

If baby is too undeveloped to eat solids (no iron-fortified cereal on the Serengeti that could be fed to a child that cannot sit up or still has it's tongue thrust reflex) surely all babies were iron deficient? If all babies were iron deficient then that is the biological norm not the exception which would be implied by 'deficient'....

Or is this a modern phenomena? In which case what are we doing wrong to cause our babies to be deficient in iron before they have the ability to consume foods that naturally contain iron (green leafy vegetables and red meats being the ones that spring to mind)? I would then suggest that the panacea of giving iron drops or iron fortified cereals is masking the true cause of the mass 'iron deficiency' not the cure for it.

Also, excessive iron can have deleterious effects too on babies see here. Though that's not a problem for us Brits as we are all not giving enough in the first place

TruthSweet 3 out of my 4 had theirs cut straight away (and the other was BBA so no one there to do it) here in the UK. While delaying is the ideal, it's sadly not common for a number of reasons.

The supplement recommendation (particularly for vitamin D) for 6 month to 5 year olds and pregnant/breastfeeding women has been around since before WW2 rationing. I'm guessing since it has been around so long they expect the information to passed around by word of mouth.

I've only had 1 HCP say anything about it though and that was as part of a clinical trial. I did with my first 3 after 6 months (4.5 months with my 4th as part of a clinical trial, fish oil). As someone who was seemed the picture of health and ended up badly deficient (but even after blood tests that showed this, I was just told eat more until I did become quite ill due to the deficiency even with a healthy diet) I think many HCP dismiss their usage so don't pass on these recommendations.

TruthSweet see here it answers all your questions: scienceofmom.com/2011/10/12/why-is-breast-milk-so-low-in-iron/ as to how our ancestors coped

Agree of course baby isn't ready for solids which is why I'm supplementing with the brand I've been asked not to repeat, and for sure not weaning at 4 months!

Also the link you provide talks about iron in formula which I am against. Pls see my previous posts in this thread about the right dosage.

My baby gets 2.5ml a day of this supplement providing the "just right" amount of all that is needed and is thriving.

BH, it's lovely that you have such faith in paediatricians, but you are speaking from a US-centric position, and it's just not appropriate for you to talk to UK mothers as if you had the monopoly on correct information.

In the UK, paediatricians deal with sick kids, in the main. They have very little experience with well babies, and mothers can't just 'ask any paediatrician' about their babies' iron needs. If they did, because they were seeing the paed for some other reason, I am pretty sure the paed would have to look up current recommendations , which do not contain routine iron supps, because we don't have the problem of iron deficiency among young babies here. The US define iron deficiency differently (lower threshold) and have different recommendations. This is controversial, even in the US. You have iron-fortified first stage formula in the US - we don't have that here, because our experts do not think it is necessary, and because it may even be (according to some evidence) undesirable.

This is allowed, you know :) For experts to disagree, and to look at the evidence and come up with different public health recommendations, and most of all, to look at their own populations and guage what would be a sensible and practicable guideline.

To repeat: there is no case for routine iron supplementation of young babies in the UK. There is a case for routine vit d supplementation. Current public health guidance reflects this.

If you don't want to "offend" anyone BH, I would seriously avoid trotting out statements like "Oh dear, so very, very mis informed" with a 'sad face' after it. You can disagree with my own personal conclusions but just because mine are not the same as yours does not mean my information is 'wrong' or I have read/found out less about the subject than you. Mumsnet is a forum where evidence-based parenting is prized (mostly!) so patronising remarks like that are not going to cut much ice here.

I have more points I would like to bring up just now but my listless, 'anaemic' children need my attention i.e. my 10 month (corrected) is wailing at me as he is desperate to cruise the furniture as he does for hours each day at the moment and is stuck between the sofa and the table so he needs a hand to cross the gap and my almost 3 year old wants to show me the 5+ jigsaw she is doing (I doubt anyone on here is unfamiliar with the definition of the word 'cognitive' thanks. As was my GP or the consultant of our neonatal unit.)

Having lived in the US and having had my first child there I tend to agree with the Brit take on health related issues that if a child appears healthy less (intervention) is better. I know my point of view is controversial but I have had a terrible experience with the US health system despite having top medical insurance and living near a top US hospital.
My son was given a hep b shot at birth as it was customary 10 years ago (not sure it still is). As a result he had a temperature which was high enough for him to be admitted to a children hospital at 48 hours of age and for him to be treated for all possible horrible illnesses just in case until they were sure it was the vaccine and not some other terrible illness. He was perfectly healthy it turned out but DH and I went through hell. My milk didn't come In for 5 days probably due to the stress and tiredness so he was ff from the start. Later attempts at establishing bf were not very successful. Most of all we've always felt robbed of the first few days as parents at home with our healthy baby.
Im all in favour of vaccinations but why the need to give hep b vaccination to a newborn baby? This aggressive interventionist approach of US medicine can lead to undesirable results like tiktok says.

vanilla The HepB vaccine and antibiotic eye drops are still standard in most states sadly (while in the UK they are only given if the mother tests positive for those conditions it treats). I feel for the problems you had (I've had similar issues with aggressive intervention).

Like tiktok said Vitamin D is recommended (and has been for almost a century) for babies and pregnant/breastfeeding women. I haven't seen anything for iron and while I give a multi-vit/mineral syrup due to family history I've seen no call (outside of commercial drivers) for it to be rolled out as standard.

And BH, Most traditional groups (of which many still exist in the world today) not only have those things listed, they also tend to have very high meat based diets (as it is calorie dense which is needed for their type of life) so any iron deficient tends to be caught up rather quickly -- but even then, there are many nutrient-based health problems among such groups previously and now.

Nope. My HV hasn't told me either. In fact, apart from wanting everyone to wean at 4 months, there's not a lot they do tell you.

It's common knowledge that your babies iron stores are depleted by 4 months, that's probably why HVs are trying to persuade moms to wean then. If you don't (like me) want to wean then, because it's also common knowledge that you shouldn't till minimum 17 weeks, then you shouldn't just ignore the issue as it's too important, as without adequate supplies of iron, your baby will form fewer neural connections, resulting in both mental and motor impairments. Deficiencies in this mineral also affect learning, memory and attention and can be irreversible. That's why I think UK practice is behind, as clearly even these young kid HVs know babies need iron from 4 months, but say wean instead of supplement breastfeeding with a very safe dosage. Btw evolution takes a long time and is all about survival of the fittest, and as I've said before this is how the babies that survived all those years ago got their iron scienceofmom.com/2011/10/12/why-is-breast-milk-so-low-in-iron/ (not through breastmilk)

BH, "It's common knowledge that your babies iron stores are depleted by 4 months" - no, it isn't.

"that's probably why HVs are trying to persuade moms to wean then" - no, this is not the reason, and this is not what is hapening generally anyway, in the UK. HVs sometimes do advise mothers to wean because of worries about weight gain/sleeping and so on. I have never, ever heard of 'iron' being given as a reason in the UK.

You are US-centric; you think that because something is US policy it is right for everywhere else; you catastrophise and doom-monger about irreversible effects on memory and learning as if these will happen without iron supps at 4 mths; you don't understand that evidence is interpretable and that it is perfectly respectable to interpret the evidence differently and according to context.

Experts in the UK agree: babies of 4mths do not need routinely supplementing with iron; UK practice is not 'behind'; you are sounding somewhat obsessed and unhinged and I would give up if I were you :)