Ask the IBCLC: Is Vitamin D Necessary?

Q. At my baby's first visit with the pediatrician, we were told to give her Vitamin D drops. I thought my milk had all the nutrients my daughter needs? Are the drops necessary?

A. You are correct in understanding your milk to be perfectly crafted to be the sole source of your child's nutrition for the first several months of her life. Your body produces quality milk for your baby whether you eat a whole foods diet or indulge in junk food. Of course, choosing foods with high nutritional content is good for your body, especially as it recovers from pregnancy and childbirth!

Vitamin D is needed by our bodies to absorb calcium to build strong bones, among other benefits. Because of certain factors- such as spending limited time outdoors, having darker skin pigmentation, or living at high latitudes- many of us are deficient in Vitamin D.

​Even if a mother takes a multivitamin with Vitamin D, "The current recommendation of 400 IU per day for the lactating woman is insufficient to maintain blood concentrations of the parent vitamin D compound, the form that crosses from the maternal circulation into human milk." (1) This leads to insufficient amounts of Vitamin D in the mother's milk for her baby.

The American Academy of Pediatrics (AAP) recommends "breastfed and partially breastfed infants be supplemented with 400 IU per day of vitamin D beginning in the first few days of life." (2) Furthermore, unless an infant is drinking 32 ounces of Vitamin D fortified formula each day, he or she should receive the 400 IU supplement of Vitamin D each day, per the AAP's guidelines. 

Research supports the supplementation of Vitamin D for breastfed babies by two different avenues: 

• supplementing baby with 400 IU Vitamin D drops daily
• supplementing the breastfeeding mother with 6400 IU Vitamin D daily (3)

Image credit: KellyMom.com

Sources: 
​​(1) Ferrarello, Debi. “Delivering Vitamin D.” USLCA Clinical Pearls, United States Lactation Consultant Association, 27 Oct. 2015, uslca.org/delivering-d.

(2) “Vitamin D | Breastfeeding | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 24 Jan. 2018, www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/vitamin-d.html.

(3) Bonyata, Kelly. “Vitamin D and Breastfeeding: An Interview with Bruce Hollis, PhD • KellyMom.com.” KellyMom.com,  15 Jan. 2018, kellymom.com/nutrition/vitamins/vitamin-d-and-breastfeeding/.