Does my breastfed baby need Vitamin D drops?

Ask Anne…

Question: My baby just went for her two month checkup. I am exclusively breastfeeding her, and she is healthy and gaining weight well. My pediatrician told me to give her Vitamin D drops every day, and I’m wondering if that’s necessary. Why would she need anything besides my breast milk?

Answer:  Vitamin D is a fat soluble vitamin produced by exposure to sunlight. For the majority of babies, human milk contains all the Vitamin D they need, as long as the mom gets enough in her diet during her pregnancy. Most babies get enough Vitamin  D before birth to last them for several months after they’re born. If the mom doesn’t have enough Vitamin D, her baby will need to get it from sunlight or dietary supplements. Premature babies have fewer fetal stores of vitamins, so they may need additional supplementation.

Other than sunlight, the baby’s main source of Vitamin D is the stores that were laid down in his body before birth. Most well nourished mothers who eat a varied diet including dairy products fortified with Vitamin D, take vitamin pills, and have some exposure to sunlight will have plenty of Vitamin D to pass on to their babies.

Babies have been breastfed for hundreds of thousands of years without vitamin supplements, so it stands to reason that human milk has enough to meet their needs. However, until fairly recently, women and babies spent much more time in the sun than they do today. Now that we know about the link between UV rays and cancer, we cover up and use sunscreen to avoid exposure to UV rays when we go outside.

Because modern moms and babies spend less time in the sun, the American Academy of Pediatrics  recommends that all breastfed babies receive 400 mgs IU of Vitamin D drops each day. There really isn’t a down side to giving it in those doses, so it’s probably a good idea to follow their advice. Formula fed babies don’t need supplements, because formula has Vitamin D already added, just as cow’s milk you buy at the store does.

it doesn’t take much sunlight to moms and babies to get the Vitamin D they need.Just getting in and out of the car or going for occasional walk can provide all the sunlight necessary. The body can store Vitamin D from sun exposure for months, so it’s not necessary to go for walks every day, or spend lots of time in the sun.

The breastfeeding babies most at risk for Vitamin  D deficiency are those who didn’t get enough from their mom during pregnancy due to malnourishment; are premature; are dark skinned; or who get very little sunlight. The babies  of mothers who are African American or Latino, Vegans (no dairy), rarely get outside, or are covered up when they do go out (as in women who wear veils due to religious beliefs), are most at risk.

If you had a healthy diet during pregnancy, and none of the risk factors above, then your baby will probably have plenty of Vitamin D, but because a severe Vitamin D deficiency  can cause serious conditions like Rickets (a bone deformity that results in permanently bowed legs), it makes sense to give your baby the supplements to be on the safe side.

I also think it’s a good idea for nursing moms to keep taking  prenatal vitamins as long as they breastfeed, just  to help make sure their nutritional bases are covered.

Anne Smith, IBCLC
Breastfeeding Basics