Very unusually, the kellymom page doesn't reflect all the latest research. The "upper threshold" of 2000 iU is no longer considered the upper threshold. In fact, it may be more like the minimum. It is much harder to overdose on vit D than was previously thought. My own experience is that taking 2000 iU a day of Vit D (and getting sunlight) left my levels on the very low end of normal. I now take 3000 iU a day. I found
this study that gives a HUGE range of supplementation amounts that various people might need to achieve normal serum levels of vitamin D. Clearly, 2000 iu is not actually the cutoff.
Here's an article that discusses some of the recent trials and the issues surrounding Vitamin D, and summarizes some of the trials supplementing moms with vitamin D. As a PP mentioned, rickets would indicate EXTREME deficiency, but a growing body of research suggests that levels high enough to prevent rickets can still be low enough to be linked to lots of other health issues-- depression, calcium storage, difficult births, etc. Vitamin D is more important than we realized, and not having rickets does not guarantee having enough Vitamin D.
And again as PPs mentioned, humans are intended to get vitamin D through the sun, and we just aren't doing that in our modern lifestyle. Blaming breastmilk for not having enough vitamin D doesn't make any more sense than blaming breastmilk for not containing enough air. Babies are intended to produce vitamin D through sun exposure, and breastfeeding is just a secondary mechanism to get it to them, which we can use if sunlight isn't going to do the job in our latitude/ climate.
I think that all moms should recognize that their babies, and in fact their whole families, are potentially vitamin D deficient-- based on our new knowledge that we need more than we thought. What to do about it? Options:
*Make sure to get sun exposure throughout the year. Research how possible that is at your latitude, and how much daily sun exposure you need in summer and winter. Remember that sun exposure should be without sunscreen and that more uncovered areas of your body will make sun exposure more effective (it's hard to produce enough vitamin D through just face and hands).
*Supplement the older members of the family-- parents and kids old enough to have solids. You can use something like the Carlson's drop on the nipple for nurslings, easily. Pregnant and nursing moms should almost certainly supplement unless they are really vigilant about sun exposure. Ask your HCPs-- mine have all recommended the 400 iu drop for DS daily and at least 2000 iu for me.
*Supplement nursing moms so young babies don't have to be supplemented.
Here's a study that reported good results from 4000 iU daily to moms.
This study also reports good results with moms' supplementation at 2000 iu and better results at 4000 iu.
*Supplement nursing infants with a drop even if they haven't started solids. Many moms prefer to supplement themselves before solids, since obviously the risks and benefits have to be weighed here.
Sorry for the novel. I hope this info helps someone.
for my daughter. They are fabulous-- one little drop on the nipple before latching her on, and that's it!
