Vitamin D recommendations

IMG_1486Brrrr! It is bitterly cold here in Wisconsin. It takes the girls and I more time to suit up to go outside than the amount of time we can actually stand to be outdoors. Under fuzzy footed pajamas, fleece one pieces, snow pants, winter jackets, scarves, hats, mittens, and boots, my poor children can hardly move, and no flesh but that around their eyes sees the light of day.

This is why my daughters and I take vitamin D supplements. Iris still breastfeeds several times throughout the day and night, but because my vitamin D levels are insufficient, my breastmilk will not provide her with adequate levels. As ABM puts it, “Human milk is not deficient in vitamin D per se; rather, it is deficient in vitamin D when mother is deficient.”

In climates like ours, where we spend most of our lives shielded from the sun, we have a greater risk of being vitamin D deficient. Other risk factors for vitamin D deficiency include obesity and dark skin tones. With excess body fat, vitamin D becomes less available or unavailable to circulate through the system, Dr. Carol Wagner, MD explains in an ABM podcast with Dr. Anne Eglash. People with dark skin have higher levels of melanin in their skin which slows down the production of vitamin D.

Dr. Wagner points out in the podcast that diet is not a natural source of vitamin D. In fact, we get less than 10 percent of our vitamin D from diet.

Sunlight exposure is our main source.

“A single 15 minute whole body exposure to sun at mid-day in summer produces well over 10,000 IU,” according to a Creighton University report. Of course, dermatologists caution against direct sun exposure to avoid risks of skin damage and skin cancer.

Taking all of this into consideration, highly-regarded health organizations recommend vitamin D supplementation. Recommended levels are not always consistent from organization to organization.

“The American Academy of Pediatrics and the Institute of Medicine recommend a daily intake of 400 IU per day of vitamin D during the first year of life beginning in the first few days, and 600 IU for everyone over age one,” according to an AAP statement.

“Everyone…should consult their primary care professional to determine the correct amount of vitamin D they should be taking to ensure optimal vitamin D levels,” it goes on.

Still, studies reveal that “less than one-fifth of all infants ever get as much as the recommended 400 IU/d from any source, and fewer than one out of 10 breast-fed infants meet the requirement,” according to the aforementioned Creighton University report.

Children who are vitamin D deficient risk developing rickets and osteomalacia, conditions that affect bone strength. Symptoms of these conditions sometimes include and are not limited to bowing of the legs, open fontanel, bone pain and tenderness, a chest that protrudes, impaired growth, dental deformities, and delayed walking.

Dr. Wagner reports in the ABM podcast that vitamin D deficiency has many more profound effects on immune function. Vitamin D sufficiency then protects us from long latency diseases, acute infections and autoimmune diseases, she continues.

Certainly parents would like to protect their children from the conditions that may result from vitamin D deficiency, but many express concerns about introducing supplements to their exclusively breastfed infants.

Dr. Wagner reports that a breastfeeding mother can provide enough vitamin D in her breastmilk for her baby if her vitamin D levels are in the range of high 50s to low 60s. This translates to 6,400 IU of vitamin D3 per day.

“A group of researchers from the University of South Carolina found that mothers who took a supplement of 6,400 IU every day gave their babies over 800 IU of vitamin D in each liter of breast milk,” according to the Vitamin D Council.

It’s best to consult one’s health care provider before taking such a high dose of vitamin D. Fat soluble vitamins such as vitamin D are stored in the body, and can cause problems at high dose levels.

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