All infants, particularly those who are breastfed, should be given vitamin D to help prevent rickets, a potentially crippling condition in which the bones fail to grow straight and strong, the American Academy of Pediatrics (AAP) announced this week.
While breast milk is the best nutrition for babies, it may not contain enough vitamin D to meet babies' needs, particularly when infants are protected from sunlight, a natural source of the vitamin.
All infant formula sold in the U.S. contain added vitamin D, but if a baby drinks less than 500 milliliters (17 ounces) of formula each day the AAP says they should also receive supplements. Vitamin D supplements are also recommended in children and teens who do not drink at least 500 milliliters each day of milk fortified with vitamin D.
Supplements of vitamin D come in liquid form, and just a few drops in the baby's mouth before nursing will give a child all the vitamin D he or she needs. Supplementation should begin within the first two months of life, and achieve an intake of 200 international Units (IU) of vitamin D per day.
The experts say that certain shifts in society have likely contributed to this apparent paradox, in which the milk that nature produces specifically for babies does not provide them with enough of a needed vitamin.
Sunlight is a major source of vitamin D and early humans likely had skin that was better suited to their environment, which enabled them to spend enough time in the sunlight to make lots of vitamin D without worrying about skin cancer.
But today, humans have moved all over the world, often to places where their skin no longer matches their environment. Furthermore, the depletion of the ozone has forced humans to use sunscreen to protect themselves from sunlight's ultraviolet rays, and sunscreen also prevents the skin from using sunlight to make vitamin D.
Breastfeeding, although imperfect, is still best for infants say the experts. Numerous studies have linked nursing to a host of health benefits, such as higher IQ and a lower risk of sudden infant death syndrome, diabetes and chronic digestive diseases.
The AAP decided to issue recommendations about vitamin D supplements after hearing reports of rickets among breastfeeding infants.
Those cases occurred more frequently in African-American children because melanin, the pigment that darkens skin, may act as a natural sunscreen. Infants who are both dark-skinned and breastfed are at greater risk of developing vitamin D deficiency than other babies.
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