Instructions for supplementing vitamin D for mothers after giving birth

Posted by CKI Doctor To Thi Thanh Huong - Obstetrics and Gynecology Center - Vinmec Times City International Hospital

The content of vitamin D in breast milk is very low, even when the mother is being supplemented with vitamins containing vitamin D. Especially in cases of people with black skin or a pre-existing vitamin D deficiency. Vitamin D is essential to support the normal development of young bones, preventing rickets and skeletal deformities or diseases caused by weak bone structure related to calcium deficiency.

Vitamin D is a fat-soluble vitamin that exists in two forms, vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol) that play an essential role in bone formation, calcium and phosphorus metabolism in the body.
The content of vitamin D in breast milk is very low, even when the mother is being supplemented with vitamin D containing vitamin D. Especially in cases of people with black skin or a pre-existing vitamin D deficiency. Supplementing with vitamin D is essential to support the normal development of young bones, preventing rickets and skeletal deformities or diseases caused by weak bone structure related to calcium deficiency.
Breastfeeding infant rickets can occur without vitamin D supplementation (food or vitamin D supplements) or sufficient sun exposure. Therefore, all infants should be given vitamin D supplements to prevent rickets, especially those with vitamin D deficiency. However, some evidence suggests that vitamin D supplementation during lactation does not improve vitamin D levels in breast milk. Thus, different approaches can be chosen: maternal vitamin D supplementation (continuous or single high dose), or infant vitamin D supplementation (recommended dose 400 IU/day). .

Current recommendations and evidence for vitamin D supplementation for postpartum women are as follows:
Newborns under 4 months of age and pregnant and lactating women are those recommended by NICE to supplement. vitamin D . NICE and SACN recommend that pregnant and lactating women receive a routine vitamin D supplement of 10 micrograms (or 400 IU/day) daily, and that healthcare professionals advise all pregnant women and Breastfeeding the importance of vitamin D supplementation for the health and development of children. The Food and Nutrition Board of the National Academy of America recommends a supplemental dose of vitamin D for pregnant and lactating women about 600 UI/day. However, the Nutrition Board of the American Academy of Pediatrics suggests that the recommended dose of vitamin D may be higher than this recommendation. ACOG: b vitamin D supplementation at doses of 1000-2000 IU/day for pregnant women in cases of vitamin D deficiency is safe. Data on the use of high doses of vitamin D in subjects with vitamin D deficiency during pregnancy are lacking. Some recommendations from studies of Vitamin D supplementation at doses of 4000 – 6400 IU/day (10 times higher than recommended levels) to increase vitamin D concentrations in breast milk to levels that meet the vitamin D requirements of infants However, these recommendations are rarely recommended.

Note: Avoid high-dose Vitamin D supplements, one report showed that 2500 UI doses of ergocalciferol (D2) (150 times the recommended dose) resulted in toxic concentrations in breast milk.
From current evidence and recommendations, postnatal vitamin D supplementation should consider the following considerations:
In all cases, routine vitamin D supplementation with a routine dose of 400 IU/day (dose) the basis of today's vitamin tablets). Vitamin D supplementation should be specific depending on each target group: race, dark skin color, little sun exposure, vitamin D deficiency. Consider vitamin D supplementation for mothers with the aim of improving vitamin D levels in milk Mothers, instead, can provide vitamin D directly to the child. Diet with Vitamin D: Some healthy foods high in vitamin D: salmon, herring, sardines, cod liver oil, oysters, shrimp, egg yolks, mushrooms, cow's milk, orange juice, cereals ... can supplement postpartum for mothers who are breastfeeding

At Vinmec International General Hospital, there is a package maternity service as a solution to help pregnant women feel secure because of the companionship of the medical team throughout the pregnancy. When choosing Maternity Package, pregnant women can:
The pregnancy process is monitored by a team of qualified doctors Regular check-up, early detection of abnormalities Maternity package helps to facilitate the process. Birth program Newborns receive comprehensive care To register for examination and treatment at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or register online HERE HERE
References:
Unicef, 2017, Statement on vitamin d supplementation for breastfed babies. NICE, 2017, Vitamin D: supplement use in specific population groups ACOG, 2019, Vitamin D: Screening and Supplementation During Pregnancy

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