I regularly ask the parents of newborns whether they are supplementing with vitamin D. Most of them do, but not everyone. And there is still confusion whether or not one should supplement with vitamin D if one is formula-feeding.
In Canada, vitamin D supplementation has been instituted since 1927. In 1967, Health Canada together with the Canadian Pediatric Society (CPS) advised the supplementation of breastfed infants 0-12 months with 400 IU of vitamin D. In 2007, the CPS adjusted its statement to the following:
- All breastfed infants 0 -12 months should be supplemented with 400 IU of vitamin D;
- All infants 0-12 months of Afro-American and First Nations descent should be supplemented with 800 IU of vitamin D all year long, as their skin does not absorb vitamin D as well;
- During the months of October-April, all breastfed infants who live north of the 55th parallel (which is at the level of Edmonton and north) should receive 800 IU of vitamin D supplementation.
Sunlight is the main source of vitamin D in humans. However, infants are not exposed to a lot of sunlight in first year of life due to the fact that exposure to sunlight is limited during the first 6 months (since the use of sunscreen is not recommended) and after 6 months the use of sunblockers reduces the skin production of vitamin D by about 97.5%. Breastmilk does not contain enough vitamin D, therefore the supplementation is needed.
Vitamin D seems to play an increasingly important role in many diseases, varying from diabetes to multiple sclerosis. Deficiency in vitamin D is most famously linked to rickets, a disease characterized by softening of the bones which leads to easy fractures and deformities. In 2002, there were 69 confirmed cases of rickets in Canada, and 11 suspected cases.
The bottom-line is this: if your infant is breastfed, make sure s/he gets vitamin D supplementation. Talk to your physician regarding the correct dosage of vitamin D depending on your exact location. If you are formula-feeding your infant in the months of October-April living in Edmonton or North of Edmonton, you should still supplement with vitamin D, but then only with 400 IU of vitamin D.
For more information, see Baby needs more time in the sun.