Breast-fed infants and vitamin D supplements

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As recently noted by fellow staff member Rachel Mosteller in a Blogging Baby post about the low levels of Vitamin D in adolescent girls, a study in Pediatrics suggested that breast-fed babies living in northern latitudes often lack healthy levels of vitamin D, and may even be severely deficient. In northern latitudes, sunshine is too diminished in the winter for the infants to generate enough vitamin D on their own. Blood samples from 84 infants when they were about 9 months old were analyzed. Forty-nine received vitamin D, either from formula or supplements, while 35 were breast-fed and received no supplements. Eight breast-fed infants were considered to be deficient, defined as having blood levels of the active metabolite of vitamin D -- 25-hydroxyvitamin D -- (25-OHD) of less than 11 nanograms per milliliter. Two of these infants were considered to be severely deficient, with levels below 5 nanograms per milliliter.

More infants were vitamin D deficient during winter (37 percent) than during summer (2 percent), and more dark-skinned than light-skinned infants were deficient (43 percent versus 6 percent). A second study investigated breast-fed babies from ages 4 to 15 months and found that deficiency is less prevalent as babies get older.

It wasn't always this way. At the beginning of the last century, it was standard practice to give infants a teaspoon of cod liver oil, which averages about 440 IU of 25-OHD per day. When the use of baby formula became popular, enough vitamin D was added to the formula to prevent deficiency. The American Academy of Pediatrics recommends vitamin D supplements of 200 IU per day for breast-fed infants. The proviso that supplements may not be required if there is adequate exposure to sunshine, but this was never defined. If you are breast feeding your baby, you likely take Vitamin D. If not, check with your pediatrician as to how much of the vitamin you should take.

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