Vitamin D is a fat soluble vitamin that regulates the level of calcium and phosphorus in the body. Vitamin D is needed in bone metabolism to maintain and build strong bones and teeth. Vitamin D is also thought to play a role in reducing the the susceptibility to infection.
Low levels of vitamin D can cause weak bones, aches and pains, slow growth, muscle weakness, delayed walking, seizures, problems with the heart and depression.
In its severest form vitamin D deficiency causes a disease called rickets, where bones are so soft they change shape.
Vitamin D in Pregnancy
It is essential that maternal vitamin D deficiency is prevented and/or corrected during pregnancy in order to prevent babies being born with depleted stores. Current guidelines recommend that pregnant and breastfeeding women take a vitamin D supplement of 10 micrograms (400 units)
In some cases pregnant woman may require a higher dose of vitamin D. This should be always discussed with a health care professional before increasing the dose.
Sources of Vitamin D
The best source of natural vitamin D is sun exposure. Vitamin D is found in smaller amounts in the diet. Sources of dietary Vitamin D include: oily fish – such as salmon, sardines, herring and mackerel,red meat,liver,egg yolks.
Which Mothers are at risk of Vitamin D deficiency
Most of us are able to synthesise vitamin D through normal exposure of the skin to summer sunlight . The risk of deficiency increases where a mother lives in the Northern hemisphere, especially when at a higher latitude.
This risk is further increased where:
The Mother has darker skin pigmentation,
The mother breastfeeds
Where the Mother wears concealing clothing, preventing skin exposure to
Mothers who spend a lot of time indoors or use sun creams, reducing skin exposure to sunlight
Mothers with a BMI >30
Mothers with gestational diabetes.
Which babies are at risk of vitamin D deficiency?
The amount of Vitamin D a baby receives from breast feeding depends on the mother’s Vitamin D status. Babies who have an increased risk of vitamin D deficiency are:
babies from multiple pregnancies (such as twins) as the mother’s vitamin D has to be shared between the babies
• babies born in the winter months (September to April)
• babies of mothers who have a body mass index of more than 30
babies of mothers who have gestational diabetes or type 2 diabetes.
Babies with darker skin types: these include babies with African, Afro-Caribbean, Middle Eastern or Indian ethnic backgrounds
Breast Fed Babies and Vitamin D supplements in the newborn.
It is advised that where a baby is breastfed that they should be given Vitamin D supplements. The recommended dose from UNICEF is 8.5 to 10 micrograms of vitamin D per day for the first year of life. Formula fed babies will only need supplementation if they are having less than 500mls of formula per day, as Infant formula is already fortified with vitamin D.
Vitamin D and Fluoride
Fluoride is not transferred through the breastmilk therefore in areas where fluoride is not added to drinking water it is recommend to give vitamin D with fluoride. There are differing opinions to whether babies under 6 months actually need fluoride supplementations , with much literature suggesting they do not need this until 6 months of age. Introducing a fluoride supplement to a newborn infant can cause indigestion and gas issues in the baby.
How To Give Vitamin D
Vitamin D comes in tablet form or drops. With the tablets, crush between two spoons and mix with a little milk or cooled boiled tap water. For the drop put onto a spoon or into the bottle