Tuesday, October 14, 2008

Vitamin D in breastmilk

Yesterday, there were several reports in the news that the American Academy of Pediatrics was increasing the dose of vitamin D supplementation in infants.

There is growing evidence that rickets, the manifestation of severe vitamin D deficiency, can actually occur at higher circulating vitamin D levels as once thought. And there have been a flurry of vitamin D studies that are linking vitamin D deficiencies with many diseases, both chronic and acute.

Yet vitamin D is very different from the other known vitamins. The natural dietary sources are not widespread, and is most commonly found added to foods, such as milk. Our bodies were not designed to depend on dietary sources of vitamin D, it was designed to produce its own through sun exposure to the skin. However in the age of skin cancer, urbanization, and computer games, many people are simply not getting enough sun to produce it. The body's production also varies by skin color and age, so one cannot easily prescribe a certain amount in the sun, and some areas don't receive enough UV radiation in the wintertime to produce anything. Several groups have recommended conducting a vitamin D test to see if one is deficient (young and old alike). Although that is ideal, if your insurance company doesn't cover it, then you could be paying quite a hefty sum for a test.

So increasing the supplementation recommendation is a step in the right direction. Yet, another message some pediatricians have been giving out is a wrong step. And that is that "breastmilk is deficient in vitamin D". Over and over again, I heard reports of that in the news. It is important to note that if a mother has adequate vitamin D status, her milk may not be very rich in vitamin D, but it is rich enough to give to her baby. Whether that is enough for the baby is another story, but it isn't because breastmilk is deficient. It's because breastmilk wasn't designed to be the primary source of vitamin D. The sun was.

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