Does my breastfed baby need extra Vitamin D?

Why would my breastfed baby need a supplement? I thought breastmilk had everything babies need for the first 6 months!

Vitamin D builds healthy bones and a robust immune system to help fight infection!

Yes, it's true. The American Academy of Pediatrics (AAP) recommends a daily Vitamin D supplement for all breastfed babies under the age of one year, to prevent Rickets. Rickets is a disease that causes a softening and weakening of the bones, caused by deficient levels of Vitamin D, which in turn lead to an imbalance of calcium and phosphorous. Left untreated, victims may suffer from permanent bone deformities, such as bowed legs, a curved spine, and growth failure.

But how did our ancestors survive without a vitamin D supplement? They led a very different lifestyle which included prolonged periods outside, exposed to the sun! Sunlight provides a good source of Vitamin D, however, in our modern, indoor lives, we are often not exposed to enough sunlight to manufacture adequate levels. Especially at risk are babies with

melanin-rich skin that acts as a sunscreen and processes Vitamin D differently, as well as babies who live in areas that get very few hours of sunlight, such as a little Icelandic tot, born in the winter. But even if you're a red-headed Irish infant living in Florida during the summertime, you aren't spared from this recommendation, because you'll be sitting in the shade wearing a hat, mini sunglasses, and SPF 50+ mineral sunscreen. Infants shouldn't sunbathe according to the AAP, who does not recommend daily doses of direct sunlight to babies who are less than 6 months old.

Meanwhile, formula is fortified with Vitamin D, so most fully formula-fed babies do not require an additional supplement. Thirty-two ounces of formula per day provides enough Vitamin D. This means that even breastfed babies who are being supplemented with formula, need extra Vitamin D. But if you just delivered, you can relax. This supplement is not an urgent need for the newborn baby, and can be discussed with your pediatrician at one of baby’s first check-ups. Some pediatricians wait until 6 weeks to address the topic.

Once you commit to this daily regimen, you have different options. Least convenient are the Vitamin D preparations that are suspended in a ml of fluid, and have to be delivered by

syringe, or added to a bottle. They taste yucky, and your baby's taste buds might not appreciate it. They can be messy and stain clothing. More popular are the brands that pack the entire dose into a single drop that can be placed on mom’s nipple prior to baby latching, or wiped into baby’s mouth. The amount of Vitamin D in baby supplements is frequently 400 IU, which is the RDA for babies in their first year. Now some nursing moms prefer to increase their own intake of Vitamin D, instead of offering a supplement to baby. Yes, this can influence the level in your milk, but just know that continuing your prenatal vitamin won't cut it. No prenatal vitamin has enough Vitamin D to adequately boost the level in

breastmilk. Moms who are dosing baby through their milk need to take 4,000-6,400 IU per day. That's a lot of D, much more than the adult RDA of 600 IU. In fact the National Institute of Health cautions adults against taking more than 4,000 IU daily, because of the risk of side effects like GI upset, hypercalcemia, kidney stones, and more.

Talk to your doctor and your baby's pediatrician about what option is best for your family!