Human milk is a wonderful and complete source of nutrients. Many experts agree that vitamin supplements are not necessary for the normal, healthy, full-term baby that is being breastfed. There is still some controversy over the need for supplemental Vitamin D in the breastfed baby.

Most mothers have Vitamin D levels that are within the normal range (Lawrence, 1994). The amount of Vitamin D in your milk is directly related to the levels of this vitamin in your body. These levels can be influenced by diet, supplementation and exposure to ultraviolet light. Normal levels of Vitamin D in your milk are between 20 and 60 IU per liter of breastmilk (Greer, 1984.)

Breastmilk levels of this vitamin could be inadequate if you live in a cold, Northern climate where there is not much light, particularly if you are dark-skinned, but, since you have taken excellent care of yourself during your pregnancy (probably eating foods rich in Vitamin D, supplementing with Vit. D, if necessary, and getting exposure to the sun) there is a good chance that your baby's stores are sufficient.

A baby does not need much exposure to sunlight each day to boost his Vitamin D levels. Allow your baby some exposure each day to sunlight (without sunscreen.) Only about 30 minutes of exposure each week, wearing just a diaper, is required, (or two hours each week if fully clothed, without a hat) to maintain normal levels of Vitamin D (Specker et al., 1994, 1985.)

Editor's Note: In an April 7, 2003 Policy Statement, the American Academy of Pediatrics now recommends that "all infants, including those who are exclusively breastfed, have a minimum intake of 200 International Units (IU) of vitamin D per day beginning during the first two months of life ... because adequate sunlight exposure is not easily determined for a given individual."

In an April, 17, 2003 Press Release La Leche League International responds saying, "Exclusively breastfed healthy, full-term infants from birth to six months who have adequate exposure to sunlight are not at risk for developing vitamin D deficiency or rickets. Rickets occurs because of a deficiency in sunlight exposure, not because of a deficiency in human milk."

Another option, is to begin supplementation for you, rather than your baby. It has been found that by giving 60 mcg of Vitamin D each day to the mother, the levels of this vitamin in her milk will raise substantially within a period of two weeks (Hollis, 1983.) Do not take Vitamin D in amounts exceeding the recommended daily allowance, because it could cause high (and possibly toxic) levels of this vitamin to be excreted into your milk.

Most likely, your physician has recommended supplementing your infant to comply with the recommendations of the Canadian Pediatric Academy. They recommend supplementation of 10mcg per day or 400 IU of Vitamin D each day for infants. In contrast, the NIH Subcommittee on Nutrition During Lactation (1991) recommended supplementation of Vitamin D only in those breastfed babies whose moms have inadequate Vitamin D intake, and who are not regularly exposed to sunlight. The amount they have recommended for these infants is 5 to 7.5 mcg of Vitamin D per day.

As you can see, the recommendations for supplementation of this vitamin do vary. Some researchers believe that because Vitamin D supplementation is an inexpensive supplement, without much risk, it is better to be safe than sorry.

With all the conflicting information about the necessity of supplementing with Vitamin D, it can really be confusing! As a parent, learn all you can, discuss these issues with your Health Care Provider, and then, make an informed choice as to whether or not you feel Vitamin D supplementation is necessary in your circumstance and for your baby. Wishing you the best!