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BLOG: September 2008
Breastfeeding and vitamin D deficiency
One cannot think of more perfect food than mothers milk for the baby. Yet, it may not be good enough. Fairly well known, but little publicized fact is that breastfeeding can leave your baby vitamin D deficient.
The reason is that mother's milk is naturally very low in vitamin D. The average content is only 0.4 micrograms per liter. With the current official recommendation for infants of 5 micrograms a day (same as for adults), this means that your baby would need to consume as much as 12 liters of milk a day in order to satisfy its vitamin D needs from milk alone.
And that could still be far from the optimum. As with the most official recommendations nutrients-wise, this one is established based on the intake of infants that appear to be healthy in a relatively short period of time. In other words, infants that don't show obvious signs of deficiency, such as rickets. As a reference, it is fairly easy to establish that the optimum intake of vitamin D for adults is
5 to 10 times higher than the official recommendation,
and even more could be beneficial for some individuals.
Thus 200 IU (International Units) of vitamin D recommended in 2003 guidelines of the American Academy of Pediatrics could be well below your baby's needs as well (1 microgram equals 40 IU of vitamin D). Keep in mind that this is for the natural form, vitamin D3. If you are supplementing it with the lower-potency synthetic, vitamin D2 form, required intake is at least four times - and possibly up to ten times - higher.
Much of the deficiency risk can be alleviated by giving to your baby sufficient exposure to sunlight; one hour a day, or so, should go long way in providing your baby with enough of vitamin D to prevent serious deficiency. That seems to be the main reason for such a low level of this nutrient in mother's milk: it simply wasn't needed for thousands of years when we were more in the open, and with more of the body skin exposed to sunlight.
These days, supplemental vitamin D seems to be a good idea for all, infants, adolescents and adult-like. Chronic deficiency can have very serious health consequences, ranging from bone loss to cancer. A thought comes that it could even play a role in this high-cholesterol epidemic. Since the body makes vitamin D in the skin from cholesterol, its response to the chronic vitamin D deficiency could - at least in some individuals - result in elevated cholesterol production, in an attempt to get more vitamin D with given restricted amount of sunshine.
In any event, the bottom line is that sufficient vitamin D is needed for health. Make sure that you and your baby are getting enough of it.