Breastfed Babies Need Extra Vitamin D

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Main Category: Pediatrics / Children's Health
Also Included In: Nutrition / Diet;  Pregnancy / Obstetrics;  Bones / Orthopedics
Article Date: 14 Oct 2008 - 0:00 PDT

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Because of vitamin D deficiences in the diet of breastfeeding mothers, the American Academy of Pediatrics (AAP) is doubling the amount of vitamin D it recommends for infants from 200 IU per day to 400 IU per day beginning in the first two months of life. And the recommendation also extends to all other babies, children and adolescents.

The new recommendation to increase the daily intake of vitamin D for infants, children and adolescents is made in a clinical report available as a PDF download from the AAP website and expected to be published in the November issue of Pediatrics.

Co-author Dr Frank Greer, who chairs the AAP Committee on Nutrition, said:

"We are doubling the recommended amount of vitamin D children need each day because evidence has shown this could have life-long health benefits."

"Supplementation is important because most children will not get enough vitamin D through diet alone," he added.

Dr Carol Wagner, member of the AAP Section on Breastfeeding Executive Committee and who co-authored the report with Greer said:

"Breastfeeding is the best source of nutrition for infants," but "because of vitamin D deficiencies in the maternal diet, which affect the vitamin D in a mother's milk, it is important that breastfed infants receive supplements of vitamin D".

Wagner said that until we can find out the exact vitamin D requirement of lactating mothers and breastfed babies, the best way to make sure that breastfed babies get enough is to recommend a daily supplement of 400 IU.

The new recommendation follows a review of new clinical trials on vitamin D that show 400 units of vitamin D a day not only prevents but also treats rickets, the bone-softening disease.

Enough vitamin D stops children developing rickets but dietary sources are limited and there are problems with determining what is a safe amount of exposure to the sun (our skin needs sunlight to make vitamin D), Greer told the press on Monday.

There are still reports of rickets in children in the US and other Western countries where the greatest risk is in babies who are exclusively breastfed and who do not receive daily supplements of 400 IU of vitamin D a day.

The peak incidence of rickets is in babies aged between 3 and 18 months, but there are also reports of the disease in older children and adolescents.

Getting enough vitamin D in childhood is also thought to reduce the risk of developing osteoporosis (weakened bone disease) in later life. And new research shows vitamin D is also important for the immune system and the prevention of a range of autoimmune diseases, diabetes and cancer.

More specifically, the new recommendation suggests:

• Babies who are fully or partly breastfed should start having a daily supplement of 400 IU of vitamin D within a few days of birth.


• Babies who are not breastfed, and older children, who consume less than one quart (about 2 pints or 1 litre) of vitamin D-fortified formula or milk a day should also be taking a daily supplement of 400 IU of vitamin D.


• Adolescents should also be taking a daily supplement of 400 IU of vitamin D if their diet does not give them this amount every day.


• Some children may need higher doses, for instance if they are taking certain medications that put them at higher risk of vitamin D deficiency.


• Healthcare providers caring for women during their pregnancy should consider monitoring their vitamin D levels, given the growing body of evidence that vitamin D is important for fetal development.

"Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents"
Carol L. Wagner, Frank R. Greer, and the AAP Section on Breastfeeding and Committee on Nutrition.
Pediatrics, November 2008; vol 122.

Click here to download the report (PDF) from AAP website.

Source: Abstract, AAP.

Written by: Catharine Paddock, PhD.


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