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Continued from page 1 Current vitamin D supplements available in the U.S. are not ideal. Solitary vitamin D preparations (containing up to 8000 IU/mL) are too concentrated to be safe for routine home use, therefore are reserved only for clinical use. Other vitamin D supplements are available as multivitamin preparations, which contain 400 IU of vitamin D per mL, but may also provide unnecessary supplementation of other nutrients including vitamin A, C, E and K or iron, zinc and B vitamins. It should be noted that although there are generic forms of the multivitamin preparations, the commercial brands Tri-Vi-Sol and Poly-Vi-Sol are produced by the two major formula manufacturers in the U.S., who routinely violate the International Code of Marketing of Breastmilk Substitutes. In conclusion, breastfeeding remains the foundation of normal health and development; the original paradigm for nourishing and nurturing young human beings. The AAP policy recommending vitamin D supplementation in breastfed infants may appear to suggest that breastmilk is somehow inadequate. However, it is the social and environmental challenges of sunlight deficiency that may contribute to the issue of vitamin D deficiency and rickets. The decision to supplement vitamin D ultimately lies with parents or caregivers once they are presented with the facts. It is the role of the health care professionals to promote and protect breastfeeding while informing families on the risk of vitamin D deficiency. In practice, the health care professional should continue to be attentive to those breastfed infants at highest risk when recommending supplementation. This includes those individuals with darker skin pigmentation and limited sunlight exposure. Future research is needed to examine the effects of vitamin D supplementation on exclusively breastfed babies, as well as the impact of supplementation on the initiation and duration of breastfeeding. |
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References: pdf/Vitamin_D_Expert_Panel_Meeting.pdf |
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