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Vitamin D is a fat soluble vitamin necessary for bone development.
The vitamin D content of breastmilk is less than that of vitamin D fortified
milk and vitamin D fortified formula.
A breastfeeding woman may produce milk with very little vitamin D
if she is not exposed to sunlight,
drinks little milk (the major dietary source of vitamin D),
and is not continuing to take prenatal vitamins.
Infants who do not get enough vitamin D in their diet can develop rickets.
Rickets in breastfed infants is being reported in the United States.
The National Academy of Science recommends a minimum intake of 200 IU
of Vitamin D a day for all infants, children and adolescents. A very
important factor for vitamin D production is exposure to the
ultraviolet B fraction of sunlight. Due to increasing rates of skin
cancer from sunlight exposure, it is recommended that sunlight
exposure of infants, children and adults should be limited by
minimizing the time in the sun and use of sunscreens. This results in
lower production of vitamin D in the body. Human milk has an average
of 25 IU of vitamin D in 1 liter of milk. The American Academy of
Pediatrics recommends that all breastfed infants
should be supplemented with 400 IU of Vitamin D each day. This should start by 2 weeks of age.
(
AAP Vitamin D, 2008
,
AAP Breastfeeding, 2005
,
Bergstrom, 1991
,
Welch, 2000
,
Kreiter, 2000
).
(Also see
case study 7
in the
Growth and Development Section).
Research is underway on the supplementation of lactating women with vitamin D.
Basile and coworkers supplemented lactating women with high dose vitamin D at 2000 IU
or 4000 IU/day.
After 3 months of supplementation, the 4000 IU/day dosage increased the 25 OH vitamin D
level in the mother to 43 mg/dL and in the infant to 31 mg/dL compared to 34 mg/dL and
28 mg/dL in the mother and infant in the group receiving 2000 IU/day.
There were no adverse effects to either the mother or the infant (
Basile, 2006
).
Further research is ongoing to determine in a larger group of women the optimal
dosage range.
Mothers on special diets, such as vegetarian diets need to check with a
dietician or physician regarding supplements that may be needed while
they are breastfeeding their child.
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