A controversy over the issue of Vitamin D supplementation in breastfed babies has been debated for many years. Vitamin D is essential for bone and muscle development and may be obtained through food consumption and through skin exposure to sunlight. Low levels of the vitamin may result in a condition known as rickets, or in bone and muscle weakness later in life. While rickets is currently rare, the concern is that several factors may be leading to a re-emergence of the disease. First, even though breast milk is considered the most nutritious and complete food source for the growing baby, with countless additional benefits to the baby's health, there may actually be a deficiency of Vitamin D in the breast milk of most women. The concern is that when a baby is exclusively breast milk fed, the mother's body may not have enough Vitamin D stores to provide adequate amounts of the vitamin in her milk to the baby, based on data which indicate that many mothers also have low levels. Additionally, there is a major public health effort to decrease the risk of skin cancer by encouraging people to limit their sunlight exposure, so this route of Vitamin D intake is also minimized.
Yesterday, a new study was released in the journal Pediatrics which highlights this controversy and presents a strong recommendation for Vitamin D supplementation. According to the new study, even babies who are formula fed with a vitamin D-enriched formula show clinically low levels of the vitamin in circulation. Those who are breast milk fed also usually have levels below the recommended amount. The data reveals that all babies may be at risk of deficiency, no matter what their feeding method is. For this reason, the American Academy of Pediatrics (AAP) currently recommends that all babies receive oral Vitamin D supplementation in the amount of 400 IU per day, whether they are breast or bottle fed.
In Fresno, there is a high ratio of sunny days throughout the year. The winter months, when there are prolonged episodes of fog, are the only periods of time when opportunities for direct sunlight exposure are reduced. For this reason, some parents and health care providers still feel that providing approximately 30 minutes of sunlight to the breastfed baby will be an adequate method of reaching normal Vitamin D levels. Others will want to follow the AAP's guidelines and begin supplementing their babies with Vitamin D. To clarify the issues and form a well-informed decision, it is best to discuss the matter with the baby's pediatrician, who would need to prescribe the supplementation if it is warranted.