Breastfeeding and vitamin D

The prevalence and determinants of vitamin D deficiency in Indonesian infants at birth and six months of age

“…Thai investigators recently reported a similar prevalence of cord blood vitamin D deficiency (89%) to our study but with a smaller sample size (N = 94) [ 8 ]. The limited data suggest that vitamin D deficiency in pregnant women may be common in South East Asian populations, as cord blood concentrations would reflect transplacental vitamin D supply [ 29 , 30 ]. As such, there are recommendations for pregnant women relating to sun exposure in Indonesia, i.e.…”

“…Indirect supplementation of breastfeeding women is impractical as the vitamin D content in supplemented breast milk does not always provide the infants with the amount currently recommended of 400 IU per day. To achieve this amount, high doses are often required of 4000–6400 IU per day with a potential increased risk of hypercalcemia and nephrocalcinosis [ 30 , 44 , 45 , 51 ]. Therefore, direct infant supplementation is now preferentially recommended [ 30 , 44 , 45 , 51 ].…”

“…To achieve this amount, high doses are often required of 4000–6400 IU per day with a potential increased risk of hypercalcemia and nephrocalcinosis [ 30 , 44 , 45 , 51 ]. Therefore, direct infant supplementation is now preferentially recommended [ 30 , 44 , 45 , 51 ]. In Indonesia, affordability is an issue as currently available formulations (400 IU/5 mL) of vitamin D for infants are expensive, not covered by universal health coverage and so are beyond the reach of most low-income families.…”

“…International organizations such as UNICEF, national guidelines such as NICE and vitamin D experts have formulated recommendations for EBF practices in relation to ensuring the potential health benefits of vitamin, including vitamin D supplementation up to 400 IU for EBF infants or breastfeeding mothers [6,30,44,45]. Experts agree that 50 nmol/L is the minimum 25-hydroxyvitamin D concentration for bone homeostasis.…”

“…To achieve this amount, high doses are often required of 4000-6400 IU per day with a potential increased risk of hypercalcemia and nephrocalcinosis [30,44,45,51]. Therefore, direct infant supplementation is now preferentially recommended [30,44,45,51]. In Indonesia, affordability is an issue as currently available 1 Skin-sun exposure score: the frequency of uncovered/exposed arms and legs (1 = never, 2 = less than 50% of the time, 3 = more than 50% of the time, 4 = all the time).…”