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Monday, July 12, 2010

Pregnancy, Breastfeeding and Vitamin D

A new study from Britain calls for stronger Vitamin D supplements for women who are pregnant.  This is not the first study of it's kind, yet it always seems to hit the media like it's some sort of new fad.  In our age of people hiding from sun exposure, vitamin D deficiency is a common side effect. Women living in Northern climes where sun exposure may require battling with raging winter winds and snow squalls for several months a year, or having a job that keeps you indoors for a vast portion of your day may leave you with less than optimum levels of Vitamin D and therefore during pregnancy  they may be unable to pass along enough Vit D to their babies.

Pregnant women advised to take vitamin D

By Shane Starling, 05-Jul-2010

British researchers have concluded pregnant women should be advised to take vitamin D after determining there is a “strong case” to back the vitamin’s benefits.

The researchers from the University College London Institute of Child Health wrote in the British Journal of Nutrition that supplementation of vitamin D will benefit pregnant women and reduce the risk of diseases such as infantile hypocalcaemia and rickets.
They said the UK was the only country in 31 that did not officially recommend vitamin D use women of reproductive age, even though the Department of Health advises pregnant women to take 10 micrograms per day....
"The incidence of vitamin D deficiency in pregnant women in Britain is unacceptably high, especially during winter and spring,” said Dr Elina Hypponen, one of the report authors.
"This is compounded by a lack of exposure to sunlight and the limitations of an average diet to meet the optimal need. In the most severe cases, maternal vitamin D deficiency can be life threatening to a newborn.”
"We believe that the routine provision of a daily supplement throughout pregnancy would significantly decrease the number of mothers who are clearly vitamin D deficient, reducing related serious risks to their babies."
The research also highlighted the problem of women with dark skin who do not absorb as much sunlight and therefore manufacture less vitamin D in vivo.
Source: British Journal of Nutrition

 HERE to read the entire article

This also applies to breastfeeding mothers.  Many times the statement that breastmilk is lacking enough vitamin D and that therefore babies should be give Vitamin D supplements has been hashed and rehashed through the media and doctors offices over and  over again.  Yet rarely have these stated the reason WHY breastmilk might be Vitamin D deficient:  Because the Mother herself is also Deficient in Vit D!!!!  It makes sense does it not?  If mom is already not getting enough, then how can she pass on enough to her baby- either in the womb or in her breastmilk?

Pregnancy and Lactation

One of the great mysteries in human biology is the fact that most human breast milk is deficient in vitamin D. How could Nature overlook such an important nutrient in the "perfect food?" One possibility is that most human breast milk is deficient in vitamin D because most mothers are deficient in vitamin D.
Two very important papers detailing this were published by Dr. Bruce Hollis and his group from the Division of Neonatology, Department of Pediatrics, at the Medical University of South Carolina. Both papers support the concept of widespread deficiencies in pregnant women, especially black women, and both papers call for drastic upward revisions of maternal vitamin D supplementation.
One of the papers discovered that pregnant women need at least 4,000 IU a day of vitamin D to maintain both their own vitamin D levels and that of their infants. Ideally, they should receive at least 5,000 IU per day.

HERE to go to the original article with multiple links to further studies on Vit D 

Infact Canada has an excellent article about Vit D supplementation of breastfed infants.  Infact points out that most of the statements about the "deficiency" of Breastmilk is blown out  of proportion and the blatant sales pitch for liquid supplement for infants totally unnecessary.  If mom has enough, so will Baby!!!!!!
How impartial is Canada's Nutrition for Healthy Term Infants1?
A just released pamphlet* from the Canadian Pediatric Society explaining the vitamin D recommendation of the infant feeding statement, says it all. Using language designed to arouse fear in new parents, breastmilk is dismissed as nutritionally inadequate, "Breastmilk contains 15 to 40 I.U. of vitamin D per litre and does not provide your baby with an adequate intake of vitamin D". Added to this are graphic descriptions of the symptoms of rickets, all designed to create doubt and anxiety on the part of parents in a mother's ability to breastfeed. Parents are told that sunlight is not a reliable source but that a "daily vitamin D supplement is a far more reliable way." One wonders did they not read the scientific literature? Did they not read the articles about the low prevalence and that only a very select minority is at risk? Did they note in the literature that vitamin D is not naturally a dietary substance but is derived from exposure to the sun? Pushing a product with kickbacks to the profession seems to be the quick fix.
*This brochure was produced by the Canadian Pediatric Society and made possible by an educational grant from Mead Johnson Nutritionals, makers of D-VI-SOL

HERE to read the entire article on Infact Canada's website

And finally, here's what Dr. Jack Newman has to say on the topic:

Vitamin D
It seems that breastmilk does not contain much vitamin D, but it does have a little. We must assume this is as nature intended not a mistake of evolution. In fact, breastmilk is one of the few natural foods that does contain some vitamin D. We were obviously meant to get our vitamin D from being exposed to sunlight. The baby stores up vitamin D during the pregnancy and he will remain healthy without vitamin D supplementation for at least a couple of months, unless the mother herself is vitamin D deficient during the pregnancy. Vitamin D deficiency in pregnant women in Canada and the USA is uncommon, but it does exist. Outside exposure also gives your baby vitamin D even in winter, even when the sky is cloudy. A few minutes of exposure very late on a summer’s day is ample. Thirty minutes during a summer week, and an hour or so in winter, gives your baby more than enough vitamin D even if only his face is exposed.

Under unusual circumstances, it may be prudent to give the baby vitamin D. For example, in situations where exposure of the baby to ultraviolet rays of the sun is not possible (Northern Canada in winter or if the baby is never taken outside), giving the baby vitamin D drops would be advised. If you have had very little outside exposure yourself (women who are veiled are particularly at risk, especially if they are dark skinned), make sure your intake of vitamin D during the pregnancy is higher than usually recommended. Your baby may need vitamin D supplementation as well. Recent studies suggest that high intake of vitamin D while breastfeeding (4000 IU a day—10 times the usual recommended dose) does in fact increase the amount of vitamin D in the milk to levels that will protect the baby from rickets.

HERE to read the original article on NBCI website