The American Academy of Pediatrics, therefore, recommends vitamin D supplementation for all infants and children so that no one becomes deficient. Those who are deficient can develop rickets. Rickets is a softening of the bones, potentially leading to fractures and deformity.
Breastmilk most certainly contains the right amount of Vitamin D for your baby if the mother gets adequate sunlight exposure so that the baby can synthesize it, and she gets enough vitamin D in her diet. However, the problem is that most mothers are deficient in Vitamin D. The addition of a Vitamin D supplement to the mother’s diet, and increasing her exposure to sunlight will increase the vitamin content in her breastmilk. Babies are not designed to get the total amount of vitamin D that they need from the breastmilk. They also need to get some of their stores from sunlight. Now consider where we live, and this could be an issue. No problem when the weather is warm and sunny. Typical Chicago winters can be a real issue with adequate sun exposure.
What makes your baby at risk for vitamin D Deficiency?
- Both mother and baby have darker pigmented skin. They would require even more sun exposure to generate adequate vitamin. D. The darker your skin, the more sun exposure needed.
- Limited exposure of the baby to sunlight. Once again, there is less skin exposure in colder/inclement weather. We tend to bundle our little ones even more. Air pollution makes it more difficult for the sunlight to penetrate the atmosphere and reach us. However, even in warmer weather our exposure to the sun is somewhat comprised due to the use of high SPF sunscreen.
- The mother is deficient in vitamin D herself. Once again, this is usually due to her own diet and sun exposure. In addition, let’s not forget the population of women who are frequently veiled, even in warm weather.
- Living at higher altitudes, especially during winter months.
The Vitamin D stores that were laid down in the baby’s body prior to birth are the primary source of this vitamin for them, other than sunlight. If the mother is not deficient, the baby has fetal stores of vitamin D that are sufficient for about 2-3 months, and will last longer if the baby gets regular exposure to sunlight. Clearly, the mother’s vitamin D status during the pregnancy affects the baby. A mother can easily determine if her vitamin D status is adequate by a simple blood test to check parathyroid hormones. The mother could also easily take a vitamin D supplement to be sure.
The World Health Organization states that two hours is the required minimum weekly amount of sunlight for infants if only the face is expose, or 30 minutes if the upper and lower extremities are exposed. Darker-skinned infants might require more sunlight exposure. As the body stores vitamin D for future use it is not necessary to get sun exposure every single day. However, it is not recommended that your child be exposed to direct sun rays without the use of sunscreen, so this would affect the amount of Vitamin D they would get from the sun.
You could also try some foods fortified with vitamin D such as cereals, milk, or margarine. There are also some varieties of orange juice that are fortified with Vitamin D. Fatty fishes and fish oils (mackerel, sardines, salmon, herring, and cod liver oil), liver and egg yolks are foods where vitamin D are found naturally.
The AAP recommends 400IU/day of vitamin D for all breastfed infants. If your child is weaned to vitamin D fortified milk, or if your younger child is weaned to vitamin D fortified formula, further supplementation might not be necessary. Check with your doctor.