Q: How do I know if my baby is at risk of vitamin D deficiency?
A: Babies are most at risk of vitamin D deficiency if:
They are breastfed.
Their mothers don’t have enough vitamin D.
They have darker skin.
They live in northern communities.
All breastfed babies should get a daily supplement of vitamin D.
Q: Why do breastfed babies need a vitamin D supplement?
A: Breast milk is the best food you can offer your growing baby. But breast milk has only small amounts of vitamin D (4 to 40 IU per litre), which may not be enough to meet your baby’s needs. That’s why babies who are breastfed should receive a daily supplement of vitamin D from birth until they get enough from their diet.
Q: If I am breastfeeding and I eat foods rich in vitamin D, do I still need to give my baby a supplement?
A: Yes. Although some foods are good sources of vitamin D, they won’t provide enough vitamin D to enrich your breast milk to the level your baby needs.
If you are breastfeeding, talk to your doctor about whether a supplement of 2000 IU/day is right for you.
Q: What should parents look for when buying a vitamin D supplement?
A: A single vitamin D3 supplement (without other vitamins) in a liquid (drop) format is recommended for infants. Other vitamin D products such as vitamin D2 or a multivitamin (which contains vitamin D) are not suggested.
Q: Can breastfeeding mothers take a vitamin D supplement instead of giving it to the infant?
A: Current guidelines advise women of childbearing age to take a daily multivitamin, which provides between 5 and 20 µg (200 - 800 IU) of vitamin D. This level of supplementation is unlikely to sufficiently increase the concentration of vitamin D in a mother's breastmilk to meet the infant's needs (Wagner & Greer, 2008). A small number of studies have investigated the efficacy of supplementing breastfeeding mothers with high doses of vitamin D to prevent rickets in their infants (Wagner & Greer, 2008). However, more research is needed on this approach before making a change to practice recommendations.
Q: If infants are both breastfeeding and getting some formula, should they be given a vitamin D supplement?
A: Non-breastfed infants do not require a vitamin D supplement because the infant formula contains vitamin D.
Infants who are partially breastfed should receive a vitamin D supplement of 10µg (400 IU). They should get this amount regardless of their average formula intake. Their total intake from supplement and formula is not likely to exceed the upper level of 25 µg (1000 IU) per day.