The Baby and Toddler Guide

The Importance of Breast-Feeding and Vitamin D3

Breast-feeding your baby is wonderful experience. Aside from the personal beauty of it, there are many advantages to breast-feeding such as minimal cost and convenience on demand. Breast milk is a most perfect source of nutrients because it is composed of the correct amounts and appropriate types of fat, carbohydrates and proteins that infants require. Also present in breast milk are valuable antibodies from the mother. Antibodies are proteins that can never be added to any formula. They are only in breast milk, and they help protect babies from infections and allergies until their own immune system has time to develop during the first year of life. Apart from the necessary building blocks for healthy growth, digestive proteins, minerals, most vitamins, and hormones needed by infants are found in breast milk. By breast-feeding an infant, a mother provides almost everything a baby needs for healthy growth and development.

Breast milk provides nearly optimal nutrition for newborns. The one thing it almost never contains is vitamin D. When a mother has low vitamin D blood levels then her breast milk does not contain the sunshine vitamin. Because vitamin D is usually obtained by exposing skin to summer sunshine, vitamin D is that one nutrient most often deficient in breast milk.

Humans are a species essentially "designed" to make vitamin D in the skin. The amount of vitamin D produced depends on the amount of skin exposed to the sun, and the quality of sunlight that reaches the skin. The mid-day sunlight in late spring, summer and early fall has the ultraviolet light required by skin to make vitamin D. The sun shining on skin causes the skin to make this nutrient. The skin will not make any vitamin D through clothing, and not in the shade, and not if the UV index is 3 or less. If mother is rarely out in the summer sun, then her breast milk contains very little vitamin D. If babies are not out in summer sun, they will not make vitamin D. Women with darker skin colour need more sun exposure to make the same amount of vitamin D as women with lighter skin colour. These mothers generally have low vitamin D levels (1)

Babies need vitamin D for healthy growth and development especially proper growth of bones. It is the nutrient that helps calcium get into bones. Newer research is also showing that more vitamin D or sunshine during infancy seems to prevent other diseases later in life, such as juvenile diabetes or multiple sclerosis (2). To avoid the possibility of vitamin D deficiency in breast-fed infants, and the diseases associated with low vitamin D such as rickets; Paediatric Associations recommend that babies should start to be given a vitamin D supplement starting from birth onwards (3,4)

In 2005, the American Academy of Pediatrics issued a new policy statement concerning breast-feeding (4). The updated recommendation was that all breast-fed infants should receive 200 IU of oral vitamin D daily, beginning during the first 2 months of life. This latest American recommendation has become more consistent with what Health Canada has been advising for years. Health Canada recommends 400 IU of vitamin D daily for all infants, or 800 IU of vitamin D per day for infants in the north above the 53rd parallel.

The need to provide vitamin D from birth onwards makes the problem of vitamin D nutrition more complicated for mothers. Breast-feeding mothers may not want to give their infants foreign liquids or products that are not a natural component of breast-feeding, but it is so important to make sure infants are not vitamin D deficient. Giving your baby a vitamin D supplement to eliminate possible vitamin D deficiency is an important partner to breast-feeding. It is almost as important as the good diet a mother needs to eat so that her breast milk will contain all the other nutrients for her baby.

Harris SS. Vitamin D and African Americans, J Nutrition 2006; 136: 1126-9
Centers for Disease Control, Vitamin D Expert Panel Document, October 11-12, 2001 Atlanta Georgia Final Report
Vitamin D supplementation for breastfed infant 2004 Canadian infant vitamin D recommendation document
American Academy Of Pediatrics Policy Statement 2005; Pediatrics 115; 496-506

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