By Brook McHugh, M.D., Pediatric Alliance —Chartiers/McMurray Division
As I have told many parents of newborns, over and over, breastmilk has EVERYTHING in it your baby needs…except enough vitamin D! For years, pediatricians have told breastfeeding moms to supplement with 400 international units (IU) of vitamin D every day. This is typically offered as a less-than-pleasant bitter cherry liquid dropper of fluid. But, a recent study may put an end to all that!
First, why is vitamin D so important? Vitamin D is also known as the “sunshine” vitamin. It is produced in the body with sun exposure or absorbed via our GI tract from food or supplements. Vitamin D helps maintain healthy bones and teeth, and several studies have suggested it supports the immune system, protecting the body against diseases such as cancer and type 1 diabetes. On the flip side, low vitamin D status has been associated with atopic and allergic diseases such as eczema and asthma.
The study published just last week in Pediatrics compared breastfed infants who were given vitamin D orally versus infants whose nursing mothers were given high doses of vitamin D orally. The study found that:
Maternal vitamin D supplementation with 6400 IU/day safely supplies breast milk with adequate vitamin D to satisfy her nursing infant’s requirement and offers an alternate strategy to direct infant supplementation.
Great news, right? Wait, not so fast. First, 6400 IU of vitamin D per day is currently more than the recommended daily intake. Too much vitamin D has been associated with kidney problems, in particular kidney stones. Second, one study of 334 infants isn’t enough to completely change practice. In an accompanying commentary, pediatrician Lydia Furman calls the study “elegant.” However, after considering the obstacles of providing nursing mothers adequate vitamin D supplements, Dr. Furman instead calls for universal vitamin D supplementation for all babies, starting on day one:
Certainly it is counterintuitive to insist that infants receiving the “perfect food” must take a dietary supplement, an issue Hollis and colleagues address at length. But in the first days of life, even infants receiving formula alone do not consume sufficient volumes to meet their vitamin D goals; the safety of early universal prescribing, with a brief educational component, is difficult to dispute.
With more studies in the works, you may see that this changes in the future. For now, breastfed infants should continue to be supplemented with 400 IU of vitamin D per day. Mothers who feed their babies formula can rest assured that around 32 oz of formula intake per day will supply their infants with the appropriate amount of vitamin D.