Following recent media coverage, the Baby Friendly Initiative has received a number of queries relating to supplementation of vitamin D for babies that are breastfeeding.
In response, we have consulted with relevant experts and produced the following statement:
Breastfeeding has a fundamental positive impact on the short, medium and long-term health of children and has an important and lasting impact on women’s health. Not breastfeeding contributes to infant mortality, hospitalisation for preventable diseases, increased rates of childhood diabetes and obesity, and adult disease.
However, concerns are being raised about the low level of vitamin D in breastmilk, since deficiency can lead to seizures, developmental delay and rickets. Vitamin D deficiency is unusual in babies born at term to mothers with adequate vitamin D status. Additionally, most are able to synthesise vitamin D through normal exposure to summer sunlight but some groups have been shown to be at increased risk of insufficiency or deficiency, including:
- Babies of mothers with darker skin types, particularly when living in high latitude areas such as the UK where the winter sun provides little or no access to vitamin D;
- Babies and mothers who wear concealing clothing, preventing skin exposure to sunlight;
- Babies and mothers who spend a lot of time indoors or use sun creams critically reducing exposure to sunlight;
- Babies of obese mothers (BMI >30).
It is essential that vitamin D deficiency is prevented and / or corrected during pregnancy in order to prevent babies being born with depleted stores. A baby born deficient in vitamin D will not restore their levels from breastmilk alone.
The National Institute for Health and Clinical Excellence (NICE) recommends that pregnant and lactating women take a vitamin D supplement of 10 micrograms (or 400 units) daily and that health professionals inform all pregnant women about the importance of this for their health and the future health of their baby. Healthy breastfed babies born to mothers who have followed this recommendation should receive a vitamin D supplement from six months of age (as part of a multivitamin supplement). However, if the mother’s vitamin D status in pregnancy is uncertain, or if she falls into one of the risk groups, vitamin D supplements for mother and baby should be started soon after birth.
UNICEF UK Baby Friendly Initiative supports the NICE recommendations as a sensible measure to prevent the rare occurrence of vitamin D deficiency in breastfed babies and to promote the health of lactating mothers. Breastfeeding should continue to be supported and promoted for all babies.
Click here to download a PDF of the statement with references.
