Vitamin D supplements

[pudding25]

In my 'Mother and baby' magazine, a paediatrician strongly recommends that vitamin D infant drops are given daily to all babies who are breastfed or who have gone on to fresh milk. Formula milk is fortified with vitamin D.

So, does everyone agree with this? Should I be giving dd (5mth old) vitamin drops? She is mix fed -2 ff/day and the rest bf.

I thought that vit D drops were only recommended for babies that wouldn't get enough through sunlight - e.g. covered up for religious/cultural reasons, living in an area of the world with limited daylight etc.

and actually a person with white skin needs only 15 minutes of exposure to sunlight ( face and hands) to make enough vitamin D

The article says that 'Vit D is recommended for all bf babies to prevent rickets. The prob has become increasingly common in the UK due to a lack of vit d rich foods -such as oily fish etc in some women's diets, together with insufficent exposure to sunlight. It is particularly likelt to affect women who keep their skin well covered when they are outside, and women with darker skin. Prengant or bf women should take a daily supplement containing 10 micorgramns of calcium/vit d. In addition, they should spend as much time in the sun, especially during the winter months'.

Well, I have just realised that I take the well woman vitamins for bf so I am sure it contains vit d -

pudding, there are at least two threads on thie very topic still live and worth a read.

UK policy is not pushed very much, but it is the case that officially, breastfed babies over 6 mths benefit from vit supps.

There is no evidence for giving these below 6 mths, as far as I can see, though other countries (Canada, I think, and the US) have it as policy that all bf babies should have supps.

Of course all babies don't 'need' them....a short period outside on most days (not 'out in the sun for a few hours'!!! ) should ensure sufficient vit d making capacities. Dark skinned babies, babies in the north of the UK, babies who never get outside or who are always wrapped up....they may be good candidates for supps.

Most in need, I would say, are babies born in the winter, to a mother who had low vitamin D stores herself, and who then breastfeeds. So they don't get vit D from mum, from fortification or from sunlight.

At this latitude (all UK, I believe, not just the north) we can't make vitamin D from sunlight from about October to March - the sun is too low in the sky for the right wavelength of light to get to us, no matter how long you sit out.

Most concern seems to focus not on rickets (which is still, thankfully, rare, though increasing), but on a less severe but still important loss of bone health through lack of vitamin D while the bones are forming. So possible increased risks of osteporosis in later life, or osteomalacia in mid life.

I went down the route of believing vitamin drops would do no harm and may do some good, and gave them to bf DS from 6 months to about 2 years.

new research is suggesting a vitamin d deficiency in breast fed babies as it is not passed on through breast milk so some hp are making an argument for it. suggest you talk to hv about it. (the research was not anti breast feeding merely suggesting supplementation would be beneficial)

Tis a research minefield from what I have read (quite a lot, am involved through work with recommendations for this). No one is quite sure what constitutes 'vitamin D deficiency' for a start, & although the consequences are clear if it goes as far as rickets there is a huge grey area still. And then it's a nightmare trying to make it NOT an anti-bf message...

To the OP, as you are mix feeding you are already supplementing in a way - the formula will be vit D fortified. I wouldn't think that you have to give extra, but note I am not qualified to say, it's just my opinion!

Yes, Captain, you may well be right about the whole of the UK - I actually think personally that vit supps are no big deal and it is not a comment on breastmilk to recommend them

It is, though, a comment on modern day lifestyles.

Our bodies evolved assuming many things that don't happen now

• unlimited and prolonge (in modern terms) access to breastmilk, so the Vit D in breastmilk gets into the baby
• mothers and babies outside even in cold weather a lot
• mothers eating a diet naturally high in vit d which would mean they were not deficient in pregnancy or during bf, which is the same diet as the baby has when he moves onto additional foods (you would have to be really badly under-nourished and chronically so these days for your breastmilk to lack Vit D - but if you limit access to breastmilk, or put the baby on solids early, he could go short)

Vit D supps give a sort of safety net.

Bt Vit D is passed on via breastmilk (I have just checked in my Big Book) - there is not a huge amount of it in breastmilk (compared with other animal milks) but what there is is right for the human infant, as you'd expect. If a mother is herself short of Vit D (rare, but possible), then supplements given to her do result in higher levels of Vit D in her milk, and for a few babies, this may be useful - but as Vit D can be stored in the body and the mother's body can draw on these stores to supply her milk, it is probably unnecessary for everyone to worry about this

I would take issue with it being rare for mothers to be vitamin D deficient though. I have a chronic vit D deficiency due to an underlying medical problem, and have chatted about this quite a bit with my doc. According to her about 20% of white people in the UK are deficient in vitamin D, alebit asymptomatic in most cases. For those with darker skins up to 90% may have a deficiency.

In fact, although I say my vit D deficiency is due to my underlying medical condition (primary hyperparathyroidism) there is a school of thought that it can be caused by vitamin D deficiency. (Sorry, rambling a bit now, this is a pet topic of mine!)

FWIW I have probably been vitamin D deficient for a number of years pre-children, I didn't supplement (didn't know I should) and none of them have developed rickets.

Daisy - I don't know the stats, but I do know there is controversy about what the 'right' level of vit and mineral requirements are. It's certainly rare to have a symptomatic dietary insufficiency of Vit D in the UK.

how funny - i started to write a post on this today but got sidetracked. i read yesterday that the American Academy of Pediatrics has just doubled their guidance on vitamin d supplementation. they say all babies and children should be supplemented.

"To meet the new recommendation of 400 units daily, millions of children will need to take vitamin D supplements each day, the American Academy of Pediatrics said. That includes breast-fed infants ? even those who get some formula ? and many teenagers who drink little or no milk."

and

"The new advice is based on mounting research about potential benefits from vitamin D besides keeping bones strong, including suggestions that it might reduce the risk for cancer, diabetes and heart disease. But the evidence is not conclusive, and there is no consensus on how much of the vitamin would be needed for disease prevention."

also read a story in the economist last year about how rickets is on the rise in the UK.