There are so many different factors to consider when facing most of the common parenting issues.
The Nurse Judy approach is a combination of many years of medical experience, a desire to treat things as naturally as possible, a large dollop of common sense.
Vitamin D/ Is your baby getting enough. Are you???
This Post was updated March 2017 Vitamin D - Is your child getting enough?
Food superstars come and go. One
minute something is going to cure all of your ills and the next minute
it might be considered poison. (Who agrees with me that as long as
chocolate and wine are considered to have some health benefits, they
should stop doing further studies?)
One of the current favorite good
guys is vitamin D. At the same time that scientists were stressing the
importance of this vitamin, they were also discovering that many folks
are surprisingly quite vitamin D deficient without being aware of it.
There are 2 forms of vitamin D: D2 and D3. Most experts are in favor of
focusing on D3, which is the more natural form.
Years ago, vitamin D deficiency was most
associated with Rickets (a disease that causes very soft bones.) More
and more recent studies are finding that Vitamin D levels are also very
important well beyond good bone health. Deficiencies are linked to
multiple illnesses including diabetes, cancer, heart disease and even
mood disorders. There are also current studies underway to see if there
is a link between low Vitamin D levels and increased allergies. Other
studies are linking D deficiency to insomnia and ADHD. The sunshine
vitamin made the news again just this month (September 2015) in the JAMA
(Journal of American Medical Association) where there was a study linking vitamin D and cognitive health in older folks.
For several years now, the
American Academy of Pediatrics has recommended that all breastfed babies
start getting 400 IU of a vitamin D supplement within the first few
days of life. (IU stands for international units, which is a common way
that vitamin D is measured.) Quality infant formulas have vitamin D in
them. Babies who get 32 ounces of formula per day have their needs
But what about the majority of our
babies who are partially or completely breast fed? I instinctively like
to believe that breast milk is a "complete source" for all of your
baby's needs. In the case of vitamin D this is not necessarily the case.
It comes down to the mom.
The only way a baby is getting enough D
through the breast milk is if mom has a good level. Unfortunately, the
segment of the population who test the lowest for vitamin D are pregnant
and breastfeeding women. If you are a nursing mom and you are
deficient, your baby is simply not getting the amount that they need.
There are some studies that claim that a nursing mom might need to take
4,000 IU/daily to be sure the baby is getting the suggested amount of
400 IU through her milk. Giving vitamin D drops directly to the baby can
take the guesswork out of this. If you do end up giving your baby
vitamin D supplements, one of the most common brands is the Enfamil
D-Vi-SOL. One dropperful is 1 ml. This gives the daily dose of 400 IU.
Babies seem to tolerate this well.
There are some other forms out there that give 400 IU in each drop.
That is quite a difference. It is very important that you pay attention
to the form that you are giving.
If you are giving your baby a multi vitamin
supplement like Poly-Vi-Sol, that already has the D in it. Be a label
reader! While vitamin D is one of the fat soluble vitamins, you cannot
get "too much" from sun or diet. But, as with any supplement, you don’t
want to overdo it. Most studies suggest that the upper limit for safe
supplementation is 1,000 IU/day for babies or 4,000 IU for adults. There
are some current studies taking place that may in fact raise that
level, but as of now I wouldn’t recommend going beyond that upper limit
unless you are working closely your personal physician.
Children over the age of one and
all adults, should make sure they are at the very least getting 600 IU
daily. Milk and orange juice that have D added, some fatty fish, and
cod liver oil are on the short list of good dietary sources for vitamin
D, but a person would have to drink ten tall glasses of vitamin D
fortified milk each day just to get minimum levels of vitamin D into
Other foods like some mushrooms and eggs will get you a bit, but not enough to begin to make a dent in the daily requirement.
Historically much of our vitamin D
is/ was from sun exposure. Folks who live in sunny climates generally
have higher levels. Darker pigmented skin has a harder time absorbing
it. Being out in the sun, unprotected for 30 minutes 2 or 3 times a week
would probably give most people the amount they need. But wait!! Do we
really want to expose ourselves and our children to the risks associated
with sunburn? To compound things, the rays of natural sunlight that
produce vitamin D in your skin cannot penetrate glass. This means you
can’t get vitamin D from indirect sunlight in your car or at home,
In fact, our recent healthier
sunscreen practices are quite possibly the cause of our lower vitamin D
levels. Weak sunscreens (such as SPF 8) can block Vitamin D by up to
95%. It is hard to find a balance. Some exposure is healthy, but
overdoing it is problematic, Sunburn and an elevated risk of skin cancer
don’t seem like a sensible answer.
If you are a nursing mom and are
one of the many folks out there who has a low level, it is very
important that your baby get the vitamin D that they need (and yourself
as well !!) In our office we are not wedded to babies receiving a daily
supplement as long as you are sure that they are getting enough through
their milk intake. In any case, giving your baby a daily vitamin D
supplement is certainly harmless if giving the proper dose. If you
choose to skip the vitamin D recommendation, please consider getting a
blood test to see what your level is. The recommended test usually
ordered is a 25-hydroxy vitamin D level. There is some debate about what
the proper level should actually be, but everyone seems to agree that:
< 12ng/ml is severely deficient.
12-20 ng/ml still not adequate
20-50ng/ml reasonable range of normal
40% of folks tested in this country are low!! Please make sure that you and your baby are not one of those.