Vitamin D

For infants, nothing packs the
same nutritional punch as breast milk.

This is why public health
officials put so much emphasis on encouraging mothers to breastfeed their
children.

In spite of breast milk’s
reputation as a superfood for babies, it still falls short in one area.

Vitamin D

“Breast milk is an incredible
nutrient for children and has many positives, but the thing that it doesn’t
have very much of is vitamin D,” Dr. Jonathon Maguire, a pediatrician and
researcher at St. Michael’s Hospital in Toronto, told Healthline.

Maguire is the author of a new study,
published today in the American
Journal of Public Health. It recommends that children who are still
breastfeeding after one year of age may need to continue taking vitamin D
supplements to avoid health problems such as rickets.

Read More: Surprising Benefits of Vitamin D »

Current Guidelines on Vitamin D

Vitamin D promotes the
formation of strong bones and teeth by helping the body absorb and use calcium
and phosphorus.

Severe vitamin D deficiency can
lead to rickets, a weakening and softening of the bones.

Vitamin D is found in foods
like fatty fish — salmon and mackerel — and egg yolks. It’s also added to many
foods such as milk, formula, and soy milk.

The body can produce its own
vitamin D when the skin is exposed to sunlight. People living closer to the
poles, though, may not receive enough sun exposure to make vitamin D in
sufficient amounts.

Diet and low sun exposure are
both behind the lack of vitamin D in breast milk.

“Moms’ vitamin D levels just
aren’t that high,” Maguire said, “and the vitamin D isn’t passed from the
breast milk to the children.”

Which is why professional
organizations such as the American
Academy of Pediatrics
and the Canadian Paediatric
Society recommend that breastfed children are supplemented with 400 international
units (IU) of vitamin D every day for the first year of life.

Now, with
the success of public health campaigns to promote breastfeeding, more children
are breastfeed past their first birthday.

As a
result, researchers are taking a closer look at what’s going on with the
vitamin D levels of these children.

“The
issue is that after a year of age, it was unclear what happens to children’s
vitamin D levels,” Maguire said. “They’re eating other foods, so they’re
getting vitamin D presumably from other foods, but they’re also breastfeeding.”

Read More: Effects of Vitamin D Deficiency »

Vitamin D Levels Can Drop

In the
new study, researchers measured the vitamin D levels in the blood of more than
2,500 children between the ages of 1 and 5.

The
children were participating in TARGet
Kids!
, a collaboration between St. Michael’s Hospital and The
Hospital for Sick Children in Toronto.

“For each
additional month of breastfeeding beyond a year of age, the vitamin D level
goes down and it keeps going down,” Maguire said. “But for children who are
continuing to receive vitamin D supplementation, the vitamin D level in their
blood does not go down.”

By age 2,
children who were still breastfeeding had a 16 percent increased risk of being
deficient in vitamin D. By age 3, that increased to 29 percent.

More
studies are needed to confirm these results and see if they apply to other
groups of children, especially those living in sunnier areas.

This
research will be needed before organizations like the American Academy of
Pediatrics change their current guidelines.

Even so,
some welcome this study.

“We are
seeing a lot of moms who are choosing to breastfeed their babies past a year.
So I think that is really important research,” Tamara Melton, registered
dietician and Academy of Nutrition and Dietetics spokesperson, told Healthline.

Read More: Extra Facts on Vitamin D »

Simple Vitamin D Supplements

Other studies have
looked at whether giving nursing mothers larger doses of vitamin D can increase
the amount of vitamin D in their breast milk. This may not be the easiest
approach.

“We’ve
known for a long period of time that giving a very inexpensive vitamin D
supplement to children who are breastfeeding just plain works,” Maguire said.

Most
supermarkets and pharmacies carry liquid vitamin D drops suitable for children.

“I used
them when I was breastfeeding my daughters and I just put a little drop on
their tongue,” Melton said. “A couple of drops and they were good to go.”

The most
challenging part for many mothers is remembering to give their child the drops
each day.

“I
usually suggest doing it with the first feeding in the morning,” Melton said.
“Put it next to your coffee, or something like that, so you see it and grab
it.”