Ask The Expert - Breastfed Children and Vitamin D

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

This week, Registered Dietitian Preethi Rahul explains how you can manage the vitamin D intake of breastfed infants and children.

Preethi Rahul

Registered Dietitian, Diploma in Clinical Nutrition & Dietetics, Graduation in Nutrition, Food Service Management and Dietetics.
Two years of rich experience in the field of nutrition, currently working with a Multinational Corporation
Expertise in the field of Child nutrition and Diabetes
LinkedIn Profile
Contact: via email

Question:Is it true that breastfed babies need more vitamin D and can it be obtained through breast milk if the mother increases her vitamin D intake?

Answer:

Yes! Definitely breastfed babies need more vitamin D as human milk contains five metabolites of Vitamin D, providing 40-50 IU/ L of vitamin D activity. The need for additional vitamin D becomes progressively important with increasing age. Cow’s milk is usually fortified with 400 IU/L of vitamin D.

Vitamin D does not occur naturally in foods that humans normally eat. Moreover, the widespread use of sunscreens and public health recommendations to avoid sun exposure reduces dermal synthesis of vitamin D₃. Most people therefore get vitamin D₃ by taking a vitamin D supplement or by consuming vitamin D–fortified milk.

Vitamin D is undoubtedly important for fetal development and for bone development in childhood; it plays a much wider role in health and disease prevention. Vitamin D is essential for cell differentiation, the functional maintenance of membranes, as well as the functions of several organs including skin, muscle, pancreas, nerves, parathyroid gland and the immune system. It is important to understand that vitamin D is not really a vitamin; vitamin D₃ is a pre-pro hormone made in the skin in response to ultraviolet-B light exposure. Vitamin D3 is the precursor to form 25-hydroxyvitamin D₃ [25(OH)D₃], a pre hormone, which is ultimately converted to 1,25-dihydroxyvitamin D₃ [1,25(OH)₂D₃]. One of the most potent steroid hormones known, 1,25(OH)₂D has the capacity to affect many bodily functions beyond calcium metabolism.

All infant formulas sold in the United States must have a minimum vitamin D concentration of 40 IU/100 kcal (258 IU/L of a 20 kcal/oz formula) and a maximum vitamin D3 concentration of 100 IU/100 kcal (666 IU/L of a 20 kcal/oz formula).All formulas sold in the United States have at least 400 IU/L of vitamin D₃. Because most formula-fed infants ingest nearly 1 L or 1 qt of formula per day after the first month of life, they will achieve a vitamin D intake of 400 IU/day. Infants who receive a mixture of human milk and formula also should get a vitamin D supplement of 400 IU/day to ensure an adequate intake. As infants are weaned from breastfeeding and/or formula, intake of vitamin D–fortified milk should be encouraged to provide at least 400 IU/day of vitamin D.

Although vitamin D concentrations can be increased in milk of lactating women by using large vitamin D supplements, such high-dose supplementation studies in lactating women must be validated and demonstrated to be safe in larger, more representative populations of women across the world. Recommendations to universally supplement breastfeeding mothers with high dose vitamin D cannot be made at this time. Therefore, supplements given to the infant are necessary.

Check out the following articles related articles on vitamin D

Ask the Expert – Vitamin D Deficiency
40% of infants and toddlers have vitamin D deficiency – should you worry?
5 reasons to consider a multivitamin supplement

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