Does my breastfed baby need Vitamin D?

Supplementing a breastfed baby is controversial, even when that supplement is a vitamin. Nursing moms are wary of the need to give their baby anything but breastmilk. As a lactation consultant, I agree. We should be very careful about anything we tell moms to put into baby’s mouth during those early months. Couple this with the mixed messages that moms have gotten about supplements, especially vitamin D, and I don’t wonder why this is one of the most common questions that I hear from new moms.

The answer to this query is evolving. In the early years of my study and practice, I learned that fully breastfeeding infants didn’t need any supplementation prior to three months- breastmilk was complete nutrition. Then, the myriad actions of Vitamin D became a hot topic. It’s role in bone formation has been known for generations, but additional benefits to mood, immunity and cardiac health are still being discovered.

Early research on the levels of vitamin D in moms and infants led us to believe that babies couldn’t get enough from breastmilk alone. Of course the breast milk substitute (formula) companies jumped all over that. Many pediatricians prescribe a multivitamin with D that is made by one of these formula companies. This product, which will remain nameless, is filled with toxic additives that I wouldn’t give to my dogs! Read the label if you have any in your home; most of us do because it is a “gateway drug”  to supplementation. These companies know what they are doing. The directions are to mix with formula! No baby would swallow it without hiding in an artificially sweet mixture.

Until recently, my mantra was that breastfeeding didn’t pass enough Vitamin D to babies, so babies needed to be given the vitamin by mouth. I hated saying that to moms. It didn’t feel right to let a mother know that her milk wasn’t enough for her newborn. It went against everything that my instincts told me. But I knew the importance of D, and I recommended a “Vitamin D only” supplement to exclusively breastfed babies. There are good brands, without artificial dyes, sugars or harmful oils.

In 2015, a study by the American Academy of Pediatrics was released that changed my advice to moms. The results revealed that Vitamin D can be passed in healthy levels through  breastmilk. The key is to have moms take enough of it. It turns out that the dose that we were prescribing to moms, including the dosage in most prenatal vitamins, is too low. Not only is it too low for mom to raise her D to a healthy level, it is also too low to get enough of it into breastmilk. If mom’s level is low, breastmilk level will be low, and transfer to baby will be low.

So how much Vitamin D should mom take? What’s a mother to do?

Well, even if you aren’t supporting the nutritional needs of a tiny human, vitamin D levels should be higher than what was previously thought recommended. As with many laboratory blood evaluations, there is a range given for “normal”.  I don’t strive for any blood level to be normal, I want it to be optimal. To explain this further, the levels that labs use are determined by taking an average of all those previously tested. So if the normal range given by a lab for vitamin D is 30-100ng/ml,(nanograms/milliliter) you want your number to be at least 60-70ng/ml for optimum health.

Back to the study published by the  American Academy of Pediatrics: Nursing moms who took 6,400u of Vitamin D every day were able to achieve safe levels for themselves and transfer enough Vitamin D through their milk to have adequate levels for the baby.

Here is the link to the abstract if you would like to read the details:

              http://pediatrics.aappublications.org/content/early/2015/09/22/peds.2015-1669

It is possible that your busy pediatrician hasn’t had time to read this study, so if you’d like to share, print out a copy and bring to your next appointment.

Many women continue their prenatal vitamins while nursing. If you are, and you would like to figure out the dosage of additional vitamin D that you should be taking, you can use this calculation:                                     

6400 minus (amount of vitamin D in prenatal vitamin) = Dosage to supplement.

I find that this is easiest to achieve when using Vitamin D drops that come in either 500, 1,000 or 2,000 iu doses. Read the labels to be sure, because there are a few different formulations.

If you are the type who never remembers to take supplements, and you would prefer to directly supplement the baby or if you aren’t completely breastfeeding for any reason, then of course, offer daily Vitamin D drops to your little one at the dosage recommended by your pediatrician.

But please, chose a brand that isn’t made by a company that wants you to use their artificial breast milk- they have an ulterior motive. Read the labels and make sure there aren’t any dyes, preservatives or other additives with names you can’t pronounce.

If you are looking for a convenient method of ordering reputable brands of Vitamin D (or any other supplements), here is a link to Fullscript This site has a large selection of trusted brands at discounted prices and they will ship directly to your home. If you sign up, let me know so I can adjust your account for a discount. 

In conclusion, yes, your baby does need Vitamin D.  It would be wonderful if we all had enough sun exposure to absorb vitamin D naturally, but that’s a story for another day…

I am just so happy that I can support moms who want to their babies everything they need by exclusively breastfeeding for the first six months!