Children who are breastfeeding after their first birthday should take a vitamin D supplement to prevent health problems such as rickets, new research from Toronto, Canada suggests.
This holds true even if children are eating solid foods in addition to breastfeeding.
This may be important for Canadian children, and those from other northern countries, where there is less exposure to the sun's ultraviolet rays, which the body uses to produce vitamin D.
While breast milk contains many of the required nutrients for supporting growth, it does not provide adequate amounts of vitamin D.
Exclusive breastfeeding in the first year of life without vitamin D supplements is a known risk factor for rickets, a disease that leads to softening and weakening of bones. That is why the Canadian Paediatric Society and the American Academy of Pediatrics recommend that breastfed children be supplemented with 400 International Units of vitamin D every day for the first year of life.
Less is known about the relationship between the total length of time a child is breastfed and vitamin D. An increasing number of children are breastfed after their first birthday in addition to receiving solid foods and the World Health Organization recommends breastfeeding to age 2 and beyond, as mutually desired by the mother and child.
After age one, vitamin D deficiency rises in breastfed babies
The researchers, from St. Michael’s Hospital in Toronto, studied how long children were breastfed and their blood vitamin D levels using data from about 2,500 healthy children aged 1 to 5 years in Toronto. Mothers reported how long their child had been breastfed and doctors collected blood samples from the children.
Mothers also reported whether their child was taking vitamin D supplements.
Half of the children had been breastfed for 10 months or more, and 53% received vitamin D supplements.
As breastfeeding duration increased, blood vitamin D levels decreased for children who did not take supplements. For every one month of additional breastfeeding time, the odds of abnormally low vitamin D levels increased by 6%.
The pattern was so consistent that researchers predicted 16% of 2-year-olds breastfeeding but not receiving extra vitamin D would be seriously deficient, and by age 3, that would rise to 29%.
For children who did take supplements, breastfeeding duration was not tied to vitamin D levels.
These results support the American Academy of Pediatrics recommendation of vitamin D supplements of 400 IU during breastfeeding, regardless of duration.
Source: American Journal of Public Health, online February 2016.
See "Kids who drink milk alternatives also at risk for vitamin D deficiency".
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