Our skin makes Vitamin D from the sun; hence, why it is often nicknamed the “Sunshine Vitamin”. We also get it from certain foods and by supplementation. However, in Canada we have very low levels of Vitamin D for two reasons. The first is due to lack of exposure to the sun given our northern climate and long cold winters that keep us inside or bundled up when outside with minimal skin exposure. The second is our warm sunny summers where we must apply sunscreen to prevent skin cancer in turn preventing the absorption of Vitamin D.
As per Health Canada and the Canadian Dermatology Association of Canada, avoiding direct sunlight and use of sunscreens is recommended for children younger than 1 year of age [1, 2]. Both recommendations reduce the amount of the Vitamin D produced by the skin. Vitamin D supplementation is recommended for newborns as it will provide the appropriate amount their body needs early in life.
Vitamin D helps absorb the calcium that we eat so that our body can make strong bones. Babies with too little vitamin D can get rickets causing softening and weakening of the bones. What is even more important is that low levels of Vitamin D are being found to play a vital role in several chronic diseases including asthma, osteoporosis, diabetes, inflammatory bowel disease, multiple sclerosis and several types of cancer. Even if an infant is breastfeeding and gets almost all of the nutrients it needs to grow strong and healthy from breast milk, Vitamin D levels may not be high enough in the infant because of low levels in mom.
A breastfeed baby should receive 400 international units (IU) of Vitamin D daily starting after the first few days of life . During periods of less sunlight (October to April), babies in more northern communities or who have other risk factors (such as dark skin) should get 800IU per day . Supplementation can be continued until they are receiving enough Vitamin D from food.
Babies that are receiving 32oz (approximately 1L) or more of Vitamin D fortified formula per day do not need any supplement. However, if they are receiving less, they would require the same amount of supplement as a breastfeed infant.
Breastfeeding in mothers who have normal levels of Vitamin D would theoretically provide the appropriate amounts to their infant. However, with so many risk factors in Canada and a very high rate of low vitamin D levels in our population, supplementation of infants is strongly recommended. There are no known risks to Vitamin D supplementation and giving Vitamin D drops daily either onto a nipple prior to latching the infant to the breast or in a bottle is easy to do!
- Canadian Dermatology Association. Sun safe play, everyday!
- Health Canada. Vitamin D supplementation for breastfed infants – 2004 Health Canada recommendation.
- Canadian Paediatric Society, First Nations and Inuit Health Committee [Principal author: J Godel]. Vitamin D supplementation in northern Native communities. Paediatr Child Health 2002;7:459-63.
- Canadian Pediatric Society Position Statement. Vitamin D supplementation: Recommendations for Canadian mothers and infants. Posted: Oct 1 2007. Reaffirmed: Jan 30 2014.
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