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Breastfeeding and Vitamin D
When my daughter was smaller I used to frequent parenting boards. One of the hot topics on those boards was whether to give your baby vitamin supplements. You give your baby the healthiest food on earth, surely she shouldn't need any supplements? Nature doesn't make mistakes, we have survived for thousands of years without supplements. Besides, vitamin D is available in plentiful supply just from a little sunshine. Let's have a look at the myths and the facts.
Myth 1: You'll get enough vitamin D if you spend just a little time outside
This depends on where you live. Vitamin D is a hormone. Your body makes it when it is exposed to UVB radiation from the sun. The closer you are to the equator, the more UVB radiation is in the sun. In most of Europe there is no UVB in the sun whatsoever from October through March. In the north of the US there is no UVB in the sun from November through Februari. During those months your body does not make any vitamin D, not even if you spend lots of time outside.
Myth 2: Vitamin D levels in breastmilk are meant to be low
The idea is that nature doesn't make mistakes, so if breastmilk levels of vitamin D are low, that is how it is meant to be. It probably means that our children do not need much vitamin D. After all, breastmilk does not contain much protein either, but we do not give our children protein supplements, do we?
It sounds logical, but it is not true. Breastmilk levels of vitamin D are only low when mother's vitamin D intake is low. If the mother gets about 4000 IU (100 mcg) vitamin D per day, breastmilk levels are sufficient and no supplementation is necessary. This amount of vitamin D occurs naturally in three herrings, or three tablespoons of cod liver oil. I think the conclusion is that if you live in a northern country, you are meant to eat fish and spend lots of time outside during summer. Now that the sees are enourmously polluted and fish population is diminishing, high fish intake does not seem like such a good idea anymore.
If breastmilk levels were meant to be low, the levels would not depend on mother's intake. This is true for other nutrients: iron levels in breastmilk are not dependend on maternal intake and it is reasonable to assume that this means that iron levels are meant to be low.
Myth 3: Many animal products contain significant amounts of vitamin D
The only real dietary source of vitamin D is fatty fish. Dairy products contain small amounts, but you would have to eat almost two pounds of cheese to get the RDA for vitamin D.
Just like vitamin C deficiency does not only lead to scurvy, vitamin D deficiency does not just lead to rachitis. Rachitis is just the most severe form of vitamin D deficiency. In adults, low vitamin D levels are associated with osteporosis (vitamin D is more important than calcium in the prevention of osteoporosis), diabetes, MS, lung disease, breast-, prostate-, ovary- and gut cancer and heart disease.
Whether you want to supplement your child or yourself with vitamin D is an individual choice that mostly depends on where you live. I strongly feel that the dangers of not supplementing in northern countries are greater than the dangers of supplementing. This is even more important if you are dark-skinned, because the melanin in the skin blocks the UVB rays to a certain extent. At least make sure to supplement during the winter months. If you would rather not supplement your child, supplement yourself. 50-100mcg a day is enough to make your breastmilk high in vitamin D. If you want to rely on the sun, realise that sunscreen blocks UVB radiation. Make sure your child does not get sunburned.
- Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin.
- Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety.
- Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant.
- Vitamin D Fact Sheet
November 5, 2006