Breast is best

Mothers must take vitamin D supplements to protect their newborns from crippling illnesses, a new study warns.  

A fifth of American newborns (roughly 800,000 babies a year) are vitamin D deficient, figures show, leaving them at risk of brittle bones and rickets.

Mothers are urged to breastfeed, if possible, in order to give their infants the maximum dose of nutrients. 

But new research by the Mayo Clinic has confirmed what many parents fear: breast milk rarely provides enough vitamin D for newborns.

Experts insist this should not be a reason to choose bottle-feeding – which is costly, with varying levels of nutrients, and often not easy for babies to digest.

Instead, the researchers say all new mothers should be told to take up a regime of vitamin D supplements – or feed the supplements direct to their child.  

A fifth of American newborns (roughly 800,000 babies a year) are vitamin D deficient, figures show, leaving them at risk of brittle bones and rickets

Doctors do already recommend daily vitamin D supplementation, but it is not widely-discussed and adherence is poor.

The new research published in the Annals of Family Medicine was an attempt to understand how mothers absorb this advice. 

Ultimately, Dr Tom D. Thacher and colleagues concluded the only effective way to eliminate vitamin D deficiency in infants is to make maternal supplement-taking a standard procedure. 

The team surveyed 140 mothers with exclusively breastfed infants. They also spoke to 44 who used both breast milk and formula milk.   

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They found less than half of infants in the study were receiving the recommended daily vitamin D supplementation.

Given a choice, most mothers would prefer to supplement themselves to enrich their breast milk with vitamin D rather than supplement their infants.

Only 55 percent of mothers supplemented their infants with vitamin D, and only 42 percent supplemented with the 400 IU recommended.

Regarding maternal preferences, they found 88 percent of mothers preferred supplementing themselves rather than their infants, and 57 percent preferred daily to monthly supplementation. 

Mothers cited safety as most important in choosing a method of supplementation.

The authors conclude that taking maternal preferences into consideration could improve adequate intakes of vitamin D in breastfed infants. 

They offer that because most mothers take a prenatal vitamin after delivery, higher doses of vitamin D (4000-6400 IU daily) could be incorporated into the maternal supplementation routine to enrich the breast milk with vitamin D. 

They cite ease of administration and avoidance of potential toxicity to the infant from dosing errors as advantages of maternal rather than infant supplementation.

One limitation of the study is that it included mostly white mothers, and the findings might not apply to women of other racial or ethnic groups or with a high risk of vitamin D deficiency, the authors note in the Annals of Family Medicine.

Still, the findings highlight the need to educate new parents about vitamin D and make sure breastfeeding mothers take supplements themselves or give babies drops, said Dr. Lydia Furman, a researcher at Case Western Reserve University and Rainbow Babies and Children’s Hospital in Cleveland, Ohio.

‘Infants can only receive adequate vitamin D if their mothers receive adequate vitamin D and thus there is adequate vitamin D in their breast milk, or if they are supplemented,’ Furman, who wasn’t involved in the study, said. 

Some infant formulas may contain enough vitamin D to make drops unnecessary. 

But babies who consume both breast milk and formula may not get enough vitamin D and still need drops or mothers who take supplements.

Many women who breastfeed incorrectly believe that this gives babies all the nutrients they need, said Dr. Carol Wagner of the Medical University of South Carolina in Charleston.

‘There is an inherent belief that breast milk is the perfect food for their baby,’ Wagner, who wasn’t involved in the study, said.

It’s no surprise women prefer taking supplements themselves, because infant drops can be hard to remember and hard to get babies to swallow, Wagner added.

‘We have found that mothers are more apt to take medications and vitamin supplements themselves than to give anything to their infants,’ Wagner said. ‘It is much easier to give a vitamin to an adult than to an infant.’