Vitamin D supplements in breastfed babies
I had no idea that I should be giving my baby vitamin D until I saw my niece being given vitamin drops by her Mum. By this time, Mr J was 5 months old and I felt incredibly guilty that I’d somehow missed this nugget of information. I was under the impression that, because I was breastfeeding and taking vitamins myself, baby ones weren’t necessary. Despite all the health visitor, midwife and weigh-in clinic appointments, not one health professional had mentioned this to me, and I couldn’t for the life of me remember reading it anywhere.
When I was pregnant I dutifully took my 10 micrograms (µg) of vitamin D every day. I carried on taking the recommended supplements when I started breastfeeding, but it seems I’m not alone in missing the advice about supplements for your breastfed baby. Vitamin brand Nutrimum say that in a survey of 250 pregnant and breastfeeding women across the UK, less than a third were aware of the role of vitamin D in pregnancy and breastfeeding. A US survey also found that of 184 breastfeeding women, only 55% gave their babies vitamin D supplements.
The science bit
Pregnant women in the UK are advised to take vitamin D supplements throughout pregnancy. It was previously thought that the vitamin D taken by a mum in pregnancy, plus the amount passed on in breast milk, would provide her baby with sufficient vitamin D. However, this recommendation changed in July 2016 when evidence in a government report found that an exclusively breastfed baby was unlikely to maintain adequate levels for the first 6 months of life. The current NHS advice is that breastfed babies from birth up to 1 year of age should be given a daily supplement containing 8.5 to 10 µg of vitamin D. This applies whether or not mum is taking a vitamin D supplement herself. Formula milk is enriched with vitamin D, meaning that formula-fed babies should get what they need as long as they have at least 500 ml a day of formula milk.
It’s really important to understand that if you’re breastfeeding, your breast milk is enough for your baby. The concern over vitamin D comes from the fact that, in the UK, we all have relatively low exposure to sunlight which is needed to activate vitamin D in the body. In fact, the Department of Health say that, because vitamin D is quite hard to get from food alone, everyone in the UK should consider taking a vitamin D supplement over the winter months. Vitamin D is essential for bone and teeth health, and deficiency in babies can lead to complications such as rickets, delayed tooth eruption, increased risk of infection, decreased bone mass, hypocalcaemic seizures, and delay in walking.
Which vitamins should I use?
Healthy Start vitamins are available in some areas of the UK to pregnant and breastfeeding women. However, my own experience has been that these are poorly publicised and can be hard to get hold of. Other mum friends have told me that they thought they were only for low income families, and access does seem to vary by region. The drops currently contain 7.5 µg vitamin D in a daily dose, but this will increase to the recommended 8.5 µg in a new formulation available from September 2018.
It’s worth asking staff at your local children’s centre or baby clinic if Healthy Start vitamins are available, as these are free of charge. If you’re in England you can use this search function to find the closest place that gives them out. If you can’t access these, look for a multivitamin that contains the recommended 8.5 – 10 µg of Vitamin D in a daily dose. Check the packaging to see how much you need to give, as the volume varies between brands from 0.3 ml to 2.5 ml. This might not sound like a big difference, but once your baby knows what’s coming and has the ability to dodge the spoon or dropper, it’s far easier to give a smaller dose!