Take it away Emma!
News story here :
http://www.usatoday.com/ne
Vitamin D is really so crucial. And we're only just now coming to terms with HOW important it truly is --for both mum AND babe.
That said, the "study" regarding infant Vit D levels is no such thing ( http://pediatrics.aappubli
The blood testing study (maternal and newborn)
http://pediatrics.aappubli
is more (scientifically) rigorous, though I have some questions about birth interventions there, too, namely the exact age of the so-called "healthy" baby at birth (maternal stores of Vit D are ONLY transferred to the fetus in the last 2 weeks of pregnancy, so, at +/- 38 weeks). This means that many of their so-called "healthy" infants --for example, born by elective cesarean surgery, often at 38 weeks... or whom are induced-- should, in fact, be considered "late preterm" babies, and being born even this "little bit" early, will absolutely affect their Vit D levels at birth. They are not "healthy".
The best thing a woman can do to ensure her baby --breastfed or otherwise-- has sufficient Vitamin D stores throughout his/her first 6 months or so of life, is to get out in the sun during her pregnancy (or orally supplement, if she, herself, is deficient; she should demand that her caregiver checks her blood calcidiol levels in pregnancy, as it's but a simple blood req. to add to the battery of blood testing she has done, anyway). The next best thing she can do is insist that she NOT be induced (or insist that a c-section is NOT scheduled) prior to -at least-- 40 weeks. Better still, allow labour to occur spontaneously, when her baby and her body are good and ready. This is because baby's stores are dependent on mother's stores, the transfer of which occurs only at about 38 weeks gestation. Premature babies, and babies who do not stay in the womb until around this time, do NOT get the transfer and will require supplementation (think: elective cesarean surgeries, where dates are so often "off", and baby is even *earlier* than expected, giving to all these late preterm babies --who are therefore Vit D-deficient from birth).
If you are pregnant (1st or 2nd trimester), and you have one or more of the following risk factors :
-your baby is due late winter/spring
-you are NOT fair-skinned, and have an olive or darker complexion
-you wear a head covering and/or have little skin exposed when you *are* outside
-you do not get outside much
-you use sunscreen
-you live in a large city
-you live above the 41st parallel
...consider telling your HCP to give you a blood req. for "maternal serum 25-hydroxyvitamin D [25(OH)D]" or your blood calcidiol levels, or the "25(OH)D" test for Vit D levels. If your levels are low, and getting out in the sun regularly is not an option for you, you ought to seriously consider supplementing orally with Vitamin D3.
It's also imperative to know that Vit D deficiency also affects muscle performance, and since the uterus is a muscle, this could put you at a greater risk for c-section...
We also really need to stop fearing the sun as much as we do, and get out there and expose ours and baby's skin for short periods, but EVERY day, if possible. Babies that are born in late Winter and early Spring are most at risk of being deficient from birth (as mum spent most of her pregnancy out of the sunlight, gestating baby through the dark months of -a northern hemisphere- winter), and another thing to realise is that putting baby in a sunny window will NOT do the trick; the window pane filters out precisely those rays that our bodies need to make Vit D.
Honestly, your breastfed baby outside for a bit, in just a diaper (no sunscreen), a few times a week throughout the summer months is amply sufficient (darker-skinned babies, obviously, requiring more time in the sun than lighter-skinned ones). This summertime exposure will also ensure your baby's stores throughout the following winter.
Last point that is important to note : yes, we evolved from equator-dwelling folk, but as we migrated away from the equator, we humans adapted, and our skin pigmentation changed --from darker, to lighter (lighter skin allowing for less sun exposure time required to produce the same amount of Vit D in the body). If you are pale, you are much less likely to be Vit D deficient, living in the Northern Hemisphere, as compared to darker-skinned people living in the same region. In other words, if you are dark-skinned, you should really consider supplementation, and if you are dark-skinned and *pregnant*, at least be sure to get your blood calcidiol levels measured by mid-pregnancy (so you have enough time to supplement if need be, before the maternal transfer of stores occurs), and so that your newborn baby will have a liver-full of Vitamin D, to last him or her for several months.
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Just as a follow-up to the links and info I've posted, here is the official LLLI statement regarding Vit D and the breastfed baby. YES, breastmilk is complete, but our lifestyle has changed in such a way that we are now "sun-fearers", and not only do we lather on the sunscreen, we also spend far too much time indoors. We did not evolve as a species to spend so little time outside in the direct sunlight. As well, one's skin colouring IS of great importance, as is WHERE you live in the world. Babies born in late winter/early spring are also at more of a risk for Vit D deficiency. The key is to know and understand one's own risk factors, prevention, and to keep in mind that SUNLIGHT IS FREE !
Please read and pass along this info (note) to any/all breastfeeding mothers you know, as this is not just about rickets --Vit D deficiency, sadly, leads to a host of other problems and (autoimmune) diseases.
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(October 16, 2008) Schaumburg, IL - La Leche League International
encourages all mothers to recognize the importance of vitamin D to the
health of their children. Recent research shows that due to current
lifestyles, breastfeeding mothers may not have enough vitamin D in
their own bodies to pass to their infants through breastmilk.
In October 2008, the American Academy of Pediatrics recommended that
infants receive 400 IU a day of vitamin D, beginning in the first few
days of life. Children who do not receive enough vitamin D are at risk
for rickets and increased risk for infections, autoimmune diseases,
cancer, diabetes, and osteoporosis.
Vitamin D is mainly acquired through exposure to sunlight and
secondarily through food. Research shows that the adoption of indoor
lifestyles and the use of sunscreen have seriously depleted vitamin D
in most women. The ability to acquire adequate amounts of vitamin D
through sunlight depends on skin color and geographic location.
Dark-skinned people can require up to six times the amount of sunlight
as light-skinned people. People living near the equator can obtain
vitamin D for 12 months of the year while those living in northern and
southern climates may only absorb vitamin D for six or fewer months of
the year.
For many years, La Leche League International has offered the
research-based recommendation that exclusively breastfed babies
received all the vitamin D necessary through mother’s milk. Health care
professionals now have a better understanding of the function of
vitamin D and the amounts required, and the newest research shows this
is only true when mothers themselves have enough vitamin D. Statistics
indicate that a large percentage of women do not have adequate amounts
of vitamin D in their bodies.
La Leche League International acknowledges that breastfeeding
mothers who have adequate amounts of vitamin D in their bodies can
successfully provide enough vitamin D to their children through
breastmilk. It is recommended that pregnant and nursing mothers obtain
adequate vitamin D or supplement as necessary. Health care providers
may recommend that women who are unsure of their vitamin D status
undergo a simple blood test before choosing not to supplement.
Parents or health care providers who want more information on
rickets, vitamin D in human milk, or other information on breastfeeding
issues may call La Leche League International at (847) 519-7730 or
visit our Web site at www.llli.org.
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UPDATE : May 1, 2010
More recent research confirms crucial importance of adequate levels of Vitamin D in pregnant women:
http://www.cnn.com/2010/HE
