Vitamin D supplements for breastfed babies

The article was professionally consulted with Master, Doctor Phan Ngoc Hai - Doctor of Pediatrics - Neonatology - Department of Pediatrics - Neonatology - Vinmec Danang International General Hospital.

Vitamin D is needed to support healthy bone growth and prevent rickets, a condition that causes bones to become weak or deformed. Vitamin D-deficiency rickets in breastfed infants is rare, but it can occur if babies are not getting vitamin D supplements from food, vitamin D supplements, or adequate exposure to sunlight. sun light.

Vitamin D is a fat-soluble vitamin that exists in two forms, vitamin D3 or cholecalciferol in mammalian form, and vitamin D2 or ergocalciferol derived from fungi. From a nutritional perspective, both forms are metabolized similarly. At birth, newborns have limited vitamin D stores, mainly reflecting maternal metabolism during pregnancy. After birth, infants can get vitamin D through breast milk (0.5-1.8 micrograms per liter) and through supplements.

The answer is no. The best biological indicator to assess the body's vitamin D stores from all sources is the serum 25-hydroxyvitamin D (25(OH) D) concentration. 25(OH)D concentration values ​​below 30 nanomol/liter (nmol/L) suggest a high risk of vitamin D deficiency, while healthy levels for infants are thought to be greater than or equal to 50 nmol/L. L.
Body stores can be reduced by 50% in less than a month in infants, and therefore without a source of vitamin D, vitamin D deficiency can progress rapidly.
Exclusively breastfed babies will not provide enough vitamin D for babies, even if mothers are taking vitamins that contain vitamin D. Shortly after birth, most babies will need extra. a source of vitamin D.

Vitamin D is needed to maintain blood calcium and bone health. Consequences of vitamin D deficiency in infants are characterized by soft bones (rickets), seizures due to low calcium levels, and difficulty breathing. At the time of diagnosis, children with vitamin D deficiency rickets had very low serum 25(OH)D levels, below 25 nmol/L, and most had not received vitamin D supplementation. Vitamin D deficiency is also thought to increase risk of other diseases including type 1 diabetes later in life at a very young age.
Vitamin D helps babies use calcium from breast milk or formula to develop strong teeth and bones. Babies who don't get enough vitamin D can develop tooth decay and other dental problems later in life. In addition, vitamin D deficiency can also cause rickets, a disease that results in weak or poorly formed bones. Before vitamin D was routinely added to foods such as milk products and formula, rickets was more common today.
To avoid developing vitamin D deficiency, the American Academy of Pediatrics recommends that breastfed and partially breastfed infants receive 400 IU of vitamin D daily, beginning within a few days of birth. Vitamin D supplementation should be continued unless the infant is weaned and using at least 1 liter per day (about 1 liter per day) of vitamin D fortified formula. Any infant receiving <1 liter or 1 quart of formula per day requires an alternative to receive 400 IU/day of vitamin D, such as through vitamin D supplementation.

Vitamin D deficiency in infants is common worldwide, encompassing many geographies and cultures. This is partly because not all health care practitioners recommend routine vitamin D supplementation even if exclusive breastfeeding and dark skin are considered. Furthermore, parental noncompliance with vitamin D supplementation is a common problem, in some cases due to parents' perception that their child does not like the supplements.
Vitamin D can also be made in the skin of infants when exposed to beta ultraviolet solar radiation. However, at latitudes greater than 37 degrees North or South, beta radiation is too low to produce vitamin D during the late fall to early spring months. In addition, the skin's melanin pigment absorbs beta radiation and thus it limits the ability of people to make vitamin D for people with dark skin. Parents often limit their children's exposure to ultraviolet solar radiation by wearing hats, wrapping blankets and avoiding direct sunlight. This means that while vitamin D can be made in the skin in some regions and seasons, infants' limited sun exposure makes this source minimal. Therefore, the main sources of vitamin D for infants include vitamin D from the mother during pregnancy and after birth from diet and supplements.
The risk of vitamin D deficiency increases when infants have limited exposure to sunlight or when infants do not absorb adequate amounts of vitamin D. Other factors that reduce the amount of vitamin D that can be made from sunlight Sunlight includes:
Living at high latitudes (near the poles), especially during the winter months. High levels of air pollution. Dense clouds. The extent to which clothing covers the skin. Use sunscreen. The race has dark skin.

As mentioned above, babies who are exclusively or partially breastfed need a vitamin D supplement as well. Although breast milk in general provides excellent nutrition for babies, they do not contain the necessary amount of vitamin D for babies. growth and healthy bones. So, if you're breastfeeding, your pediatrician will likely recommend giving your baby vitamin D drops starting soon after birth.
Our bodies produce vitamin D when the skin is exposed to the sun, but sun exposure can damage the skin and increase the risk of skin cancer. For this reason, the American Academy of Pediatrics (AAP) recommends keeping babies out of direct sunlight and protecting their skin with clothing and hats. As a result, many babies do not produce vitamin D on their own and need supplementation in the right amounts.
Worldwide there seems to be consensus that infants are at high risk of vitamin D deficiency and that vitamin D supplementation for exclusively breastfed infants is recommended for the primary prevention of vitamin D deficiency and rickets. Increased public health activities including dissemination of information to parents and health care providers are needed to reduce the prevalence of vitamin D deficiency.

The most widely accepted approach to building healthy vitamin D stores in infants is vitamin D supplementation. Based on randomized controlled trials, 5 to 10 micrograms daily is sufficient to support Support serum 25(OH)D concentration of 50 nmol/L in neonates up to one year of age. Educational strategies aimed at parents are effective in increasing infant vitamin D status. The use of high-dose bolus supplementation to rapidly increase infant stores is not yet recommended as a public health strategy.
Infant vitamin D intake recommendations are available from various organizations around the world and are typically 5 to 10 micrograms per day. Some organizations recommend larger amounts (25 to 30 micrograms per day) as a supplement for exclusive breastfeeding. Supplementation is generally recommended starting during the first month postpartum and continuing until the required amount of vitamin D can be obtained from other foods.
The AAP recommends that breastfed and partially breastfed infants get 400 international units (IU) of vitamin D per day. Formula provides vitamin D, but your baby will need to drink at least 32 ounces of formula a day to get 400 IU. The AAP recommends vitamin D supplementation beginning soon after birth and continuing until a child's first birthday, when they can start drinking vitamin D fortified whole milk.

While one study found that infants' vitamin D levels increased when their mothers took high doses of vitamin D supplements, there was not enough evidence for the AAP to change its recommendation to give breastfed infants 400 IU supplements. vitamin D.

For some cultures and countries, the introduction of milk alternatives, such as fortified cow's milk or infant formula and cereals may provide an additional source of vitamin D. A strategy to increase infant vitamin D intake using high-dose maternal supplementation shows potential in preventing vitamin D deficiency in infants, but is not within health policy recommendations. public at this time. If an infant is diagnosed with rickets, global consensus recommendations for the treatment of vitamin D deficiency have recently been published.
Some children readily accept vitamins in droppers, while others may not. But don't give up, here are some tips to help your child take liquid vitamins:
After your baby has had a feed and is most satisfied, move quickly but gently to bring the dropper to his or her mouth. This can cause a child not to realize how much vitamin D he or she is taking. Point the dropper tip to the inside of the cheek so that the child is less likely to purse his lips and spit. Add vitamin D to the pumped breast milk bottle. To make sure your baby gets the full dose, mix it with a small amount of milk and feed it when the baby is hungry to use up all of it. Then let the child drink the rest of the milk and keep it separate. Once your baby has started solids, try mixing liquid vitamins into mashed fruit or vegetables or into infant cereal. The flavors of vitamin D supplements vary, so you may want to experiment with different brands if your child is constantly protesting and spitting food out.
Breast milk is an invaluable source of nutrition that no other milk can match. Breastfeeding is not only good for the baby, but also improves the health of the mother. However, in breast milk there is a drawback that it does not provide enough vitamin D that the baby needs. Therefore, it is necessary to supplement with an adequate dose of vitamin D.
For children to be healthy and develop well, it is necessary to have a nutritious diet in terms of quantity and quality balance. If children are not provided with adequate and balanced nutrients, it will lead to diseases of excess or lack of nutrients, which adversely affect the comprehensive development of children in terms of physical, mental and motor skills.
Children who do not eat properly are at risk of micro-mineral deficiency causing anorexia, growth retardation, malabsorption,... If they notice the above signs, parents should supplement their children with products. The supplement contains lysine, essential micro-minerals and vitamins such as zinc, chromium, selenium, and B vitamins to help fully meet the nutritional needs of children. At the same time, these essential vitamins also support digestion, enhance nutrient absorption, help improve anorexia, and help children eat well.
Parents can learn more:
Signs of zinc deficiency in children
Micronutrient deficiency and failure to gain weight in children
Pediatrics Department at Vinmec International General Hospital is the address to receive and visit examine diseases that infants as well as young children are susceptible to: viral fever, bacterial fever, otitis media, pneumonia in children,... With modern equipment, sterile space, minimized effects as well as the risk of disease transmission. Along with that is the dedication from the doctors with professional experience with pediatric patients, making the examination no longer a concern of the parents.
Please regularly visit Vinmec.com website and update useful information to take care of your baby and family.

Reference source: babycenter.com