On vitamin D deficiency and vitamin supplementation for babies
A recent study gives the following disturbing statistics:
- 40% of American babies and toddlers don’t get enough vitamin D
- 12% of infants and young children are already deficient in vitamin D,
- 28% are at risk for vitamin D deficiency
Those especially at risk are breastfed babies. This is due to the fact that while baby formula is fortified with vitamin D, breastmilk seems to be deficient in this essential vitamin.
According to the NIH Office of Dietary Supplements, the American Academy of Pediatrics recommends that breastfed infants (exclusively and partially) should be given vitamin D supplement of 400 IU/day until they are weaned or shifted fully to vitamin D-fortified formula or whole milk.
In a previous post, Tamsen Butler recalls her experience with infant vitamin prescription for her breastfed baby. I can fully understand her feelings. We are fully convinced that breast milk is the best food for our babies and having to give them supplements goes against the grain.
In Europe, giving vitamin D or any vitamin supplement for that matter to infants is not a common practice. Breast milk is usually deemed to provide all the nutrients that a baby needs in the first months. I mixed-fed my twins for 4 months with pumped breast milk and formula. They needed a special formula for premiees because they were born premature with low birth weights. However, they never got any vitamin supplements at any time nor did our paediatrician ever mention it. At 12 months, like most German children of their age, they were drinking the normal milk we buy in the supermarket with 1.5% fat content but unfortified with vitamin D.
Older children in the US are also at risk for vitamin D deficiency. This is because vitamin D in the food we eat is very limited. Instead, our main source of vitamin is sun exposure. Supplementation is also recommended for older children and adolescents who don’t get the recommended daily intake of vitamin D in their daily diet.
While most milk products in the US are vitamin D-fortified, this is not true in Germany and Switzerland and many other European countries. Some foodstuffs though like breakfast cereals and fruit drinks may be fortified. However, our main source of vitamin D in Europe is still sun exposure. In winter time in Zurich where it can be pretty foggy, train signs would tell the passengers which mountain they should go to get some sun.
In recent years, there is more pressure for supplementation, even in Europe. Vitamin D deficiency is especially prevalent in northern European countries in spring and winter. Finland started fortification of some food products in 2005. In 2007, the Irish Food safety Authority (FSAI) recommended a nationwide supplementation in infants under 12 months old. In recent years, vitamin D deficiency has become a global problem. Lifestyle changes all over the world led people to spend less and less time outdoors, thereby less exposure to the sun. Even Singaporeans who live right smack on the equator are having health problems from lack of sunlight.
However, the practice of routine vitamin supplementation is still a subject for controversy. Many health experts recommend that exposure to midday sun without sunscreen is the best way to get vitamin D. Dermatology experts maintain that diet and supplements, and not sunshine should be the main source of vitamin D. This is to counter the risk for skin cancer. The American Heart Association does not recommend taking vitamin supplements in general.