Health Brief
Issue: Vitamin D deficiency is common in children and adults. During childhood, vitamin D deficiency can cause growth retardation, skeletal deformities, and increase risk of hip fracture later in life. Studies have shown that increasing vitamin D intake is associated with decreased risk for many chronic illness such as cancer, autoimmune disease, infectious disease and cardiovascular disease(1). Vitamin D supplementation is needed for all breastfed infants and mothers.
Pragmatic bottom line/policy implications:
1- Lactating women need 4000IU/ day via sun exposure, supplement or foods of vitamin D to satisfy mother and infant demand (1).
2- Without adequate sun exposure children and adults would require approximately 800-1000IU/day of vitamin D(1).
3- All breastfed infants should be provided with a Vitamin D through supplementation or formula (2).
Policy one is based on the fact that Human Milk contains little vitamin D (approximately 20IU/ liter) and women who are deficient in vitamin D provide even less. Studies showed that lactating women need 4000IU/ day to satisfy mother and infant demand. In reference to policy two, the current Institute of Medicine’s requirement of 200IU for children isn’t providing enough for the average child because they need 800-1000IU/day(1). The third is based on a study in which consumption of vitamin D from vitamin supplements or formula was effective in preventing vitamin D deficiency (2).
How We Know: Researchers conducted a study on breastfed infants and mothers in a community where maternal sunshine exposure was low. The study was done on 90 infants and mothers and found that 61% of mothers and 82% of infants have hypovitaminosis D (low vitamin D levels) (2). Another study took blood samples and dietary records of 84 breastfed infants over 280 days. Results showed that 10% of unsupplemented infants were vitamin D deficient. Vitamin D deficiency was more prevalent among dark skinned infants, and during the winter months. Vitamin D deficiency didn’t occur in any of the supplemented babies (3). A research study done on 380 infants and toddlers that came in for routine health visits showed that 12.1% were vitamin D deficient and 40% were below the optimal threshold (4). A study done on 19 mothers showed that mothers who were given 6400IU/day of vitamin D significantly increased serum 25 OHD and vitamin D in infants. Those infants whose mothers received 6400IU/day of vitamin D had equivalent levels of 25 OHD as those infants who were only given oral vitamin D supplementation(5). Another study found that vitamin D supplemented in children reduced risk of type 1 diabetes by 80%. Vitamin D deficiency can cause increased insulin resistance and decreased insulin production. In one study of adults, vitamin D supplement combined with calcium supplement also reduced type II diabetes by 33%(1). Studies showed in patients with hypertension who were given vitamin D supplements 3 times/week for 3 months had a decrease in blood pressure by 6mm Hg. Similar studies were done and showed the same results for rheumatoid arthritis, and osteoarthritis (5).
Findings from research: Suboptimal vitamin D status is common among otherwise healthy young children. Unless mothers are supplementing 4000IU/day of vitamin D infants need at least 400IU/day(5). Infants can get adequate vitamin D through supplementation or through a formula.
Conclusion: Study concluded that consumption of vitamin D from vitamin supplements or formula is affective in preventing vitamin D deficiency. All breastfed infants should be provided with a Vitamin D supplementation (3).
Works Cited:
1. Holick MF. Vitamin D Deficiency. New England Journal of Medicine. 2007;357:266-281.
2. Dawodu A, Agarwal M, Hossain M, Kochiyil J, Zayed R. Hypovitaminosis D and Vitamin D deficiency in exclusively breastfeeding. The Journal of Pediatrics. 2003;142(2):169-173
3. Ziegler EE, Hollis BW, Nelson SE, Jeter JM. Vitamin D Deficiency in Breastfed Infants in Iowa. Journal of Pediatrics. 2006;118(2):603-610. 118 No. 2 August 1, 2006
4. Gordon CM, Feldman HA, Sinclair L, Williams AL. Prevalence of Vitamin D Deficiency Among Healthy Infants and Toddlers. Arch Pediatr Adolesc Med. 2008;162(6):505-512.
5. Wagner CL, Hulsey TC, Fanning D, Ebeling M, Hollis BWB., Breastfeeding Medicine. 2006;10(2):59-70.
Issue: Vitamin D deficiency is common in children and adults. During childhood, vitamin D deficiency can cause growth retardation, skeletal deformities, and increase risk of hip fracture later in life. Studies have shown that increasing vitamin D intake is associated with decreased risk for many chronic illness such as cancer, autoimmune disease, infectious disease and cardiovascular disease(1). Vitamin D supplementation is needed for all breastfed infants and mothers.
Pragmatic bottom line/policy implications:
1- Lactating women need 4000IU/ day via sun exposure, supplement or foods of vitamin D to satisfy mother and infant demand (1).
2- Without adequate sun exposure children and adults would require approximately 800-1000IU/day of vitamin D(1).
3- All breastfed infants should be provided with a Vitamin D through supplementation or formula (2).
Policy one is based on the fact that Human Milk contains little vitamin D (approximately 20IU/ liter) and women who are deficient in vitamin D provide even less. Studies showed that lactating women need 4000IU/ day to satisfy mother and infant demand. In reference to policy two, the current Institute of Medicine’s requirement of 200IU for children isn’t providing enough for the average child because they need 800-1000IU/day(1). The third is based on a study in which consumption of vitamin D from vitamin supplements or formula was effective in preventing vitamin D deficiency (2).
How We Know: Researchers conducted a study on breastfed infants and mothers in a community where maternal sunshine exposure was low. The study was done on 90 infants and mothers and found that 61% of mothers and 82% of infants have hypovitaminosis D (low vitamin D levels) (2). Another study took blood samples and dietary records of 84 breastfed infants over 280 days. Results showed that 10% of unsupplemented infants were vitamin D deficient. Vitamin D deficiency was more prevalent among dark skinned infants, and during the winter months. Vitamin D deficiency didn’t occur in any of the supplemented babies (3). A research study done on 380 infants and toddlers that came in for routine health visits showed that 12.1% were vitamin D deficient and 40% were below the optimal threshold (4). A study done on 19 mothers showed that mothers who were given 6400IU/day of vitamin D significantly increased serum 25 OHD and vitamin D in infants. Those infants whose mothers received 6400IU/day of vitamin D had equivalent levels of 25 OHD as those infants who were only given oral vitamin D supplementation(5). Another study found that vitamin D supplemented in children reduced risk of type 1 diabetes by 80%. Vitamin D deficiency can cause increased insulin resistance and decreased insulin production. In one study of adults, vitamin D supplement combined with calcium supplement also reduced type II diabetes by 33%(1). Studies showed in patients with hypertension who were given vitamin D supplements 3 times/week for 3 months had a decrease in blood pressure by 6mm Hg. Similar studies were done and showed the same results for rheumatoid arthritis, and osteoarthritis (5).
Findings from research: Suboptimal vitamin D status is common among otherwise healthy young children. Unless mothers are supplementing 4000IU/day of vitamin D infants need at least 400IU/day(5). Infants can get adequate vitamin D through supplementation or through a formula.
Conclusion: Study concluded that consumption of vitamin D from vitamin supplements or formula is affective in preventing vitamin D deficiency. All breastfed infants should be provided with a Vitamin D supplementation (3).
Works Cited:
1. Holick MF. Vitamin D Deficiency. New England Journal of Medicine. 2007;357:266-281.
2. Dawodu A, Agarwal M, Hossain M, Kochiyil J, Zayed R. Hypovitaminosis D and Vitamin D deficiency in exclusively breastfeeding. The Journal of Pediatrics. 2003;142(2):169-173
3. Ziegler EE, Hollis BW, Nelson SE, Jeter JM. Vitamin D Deficiency in Breastfed Infants in Iowa. Journal of Pediatrics. 2006;118(2):603-610. 118 No. 2 August 1, 2006
4. Gordon CM, Feldman HA, Sinclair L, Williams AL. Prevalence of Vitamin D Deficiency Among Healthy Infants and Toddlers. Arch Pediatr Adolesc Med. 2008;162(6):505-512.
5. Wagner CL, Hulsey TC, Fanning D, Ebeling M, Hollis BWB., Breastfeeding Medicine. 2006;10(2):59-70.