Breastfed Babies Are Not Getting Enough Vitamin D

Vitamin D is a critical nutrient, particularly for young infants, and deficiencies can cause rickets, type 1 diabetes, and possibly infections and asthma. Breast milk contains insufficient amounts of vitamin D and the sun is not a safe source for infants. Therefore, vitamin D supplementation is the recommended way to provide infants with this nutrient.

The American Academy of Pediatrics recommends 400 IU/day of supplemental vitamin D beginning within the first few days of life. They also recommend that children continue receiving vitamin D throughout childhood until they can obtain the appropriate amount through food sources.

However, according to Dr. Sina Gallo, an assistant professor in CHHS’s Department of Nutrition and Food Studies, only a quarter of breastfed infants in a local Special Supplemental Nutrition Assistance Program for Women, Infants and Children (WIC) were receiving vitamin D supplementation based on a recent survey. In a previous study, Gallo surveyed mothers of newborns who delivered in a local hospital in Montreal, Canada, and found that many more—75% of breastfed infants—were receiving vitamin D supplements.

Why is the U.S. rate so low, and what can we do to change it?

Gallo explains some of her findings from research in Loudoun County that explored these issues. “The most common reason for not supplementing vitamin D in our sample was that the pediatrician or WIC nutritionist/counselor did not recommend it. We found that having a health care professional—a doctor, nurse, or nutritionist—recommend vitamin D supplementation predicted a 30-fold higher likelihood of supplementation.”

In order to address this gap, Gallo with the cooperation of the Loudon County Health Department, prepared an educational flyer for parents. The flyer was adopted by the Virginia Department of Health and provided to WIC clinics across the state.

Gallo is careful to point out that we do not know the rates of vitamin D deficiency among WIC infants. Breastfed infants without adequate supplementation are at high risk of deficiency. Therefore, infants in the WIC program, as well as infants with darker skin color, may be at undue risk for short and long-term consequences if not supplemented.

Jarene Fleming, the State Breastfeeding Coordinator for Virginia, commented on Gallo's work, "It’s wonderful to have this level of expert research taking place right here in Virginia. Human milk is the perfect first food for infants. Dr. Gallo’s work among WIC participants has informed our work in Virginia WIC and has prompted us to highlight the importance of Vitamin D during our individual nutrition counseling sessions." She also pointed out that August is National Breastfeeding Awareness month. "Each year the Commonwealth of Virginia celebrates Breastfeeding Awareness Month. [It] gives the Virginia Department of Health and our community partners an opportunity to educate the public about the beneficial impact of breastfeeding for infants and mothers. We encourage families, Virginia WIC, breastfeeding coalitions, and other community and health organizations to celebrate breastfeeding as the ideal infant feeding method.”