Pediatrician

By Dr. Denis Leduc

: I just had a baby and I’m planning to breastfeed him. I’ve been told that he should be given a vitamin D supplement. Why is this necessary? 

: Congratulations on deciding to breastfeed your baby. Breast milk is the best food you can offer your little one. It has nutrients perfectly suited to his needs, is easily digested and contains antibodies that prevent and fight off illness. However, breast milk has only small amounts of vitamin D, which may not be enough for your baby. 

Vitamin D is essential for healthy growth and development. It helps build strong bones and teeth. Those who don’t get enough vitamin D are at risk of getting rickets, a disease that affects the way bones grow and develop.
Vitamin D comes from different sources:

Foods: In Canada, cow’s milk and margarine are fortified with vitamin D, which means it’s added to these foods during their production. Some foods — like salmon, tuna, liver and kidney — are good sources of vitamin D. But even if you eat foods that are high in vitamin D, it won’t be enough to enrich your breast milk to the level your baby needs.

Sunlight: Vitamin D is formed naturally when skin is exposed to sunlight. But because Canada is located so far north, there isn’t enough sunlight at certain times of the year and in certain places. 

Also, sunscreen and clothing, which protect babies from the harmful effects of the sun, also prevent their skin from receiving the sunlight and then forming vitamin D. 

Babies are most at risk of vitamin D deficiency if: 
• They are exclusively breastfed. 
• Their mothers are vitamin D deficient. 
• They are not exposed to enough sunlight. 
• They have darker skin. 
• They live in northern communities. 

The Canadian Pediatric Society recommends that babies who are exclusively breastfed receive a daily supplement of vitamin D from birth until they get enough from their diet. (When your baby starts eating solids at 6 months, check with your doctor about continuing supplements or not.) The recommended dose is 400 IU per day and is available as drops.
If you decide to switch your baby to a store-bought, iron-fortified formula, you will not need to supplement with Vitamin D as it is already added to the formula. 

Dr. Denis Leduc is a general pediatrician in the Montreal area. He is the Past-President of the 
Canadian Pediatric Society.  For more information on your child’s growth and development, visit the Canadian Pediatric Society’s website at www.caringforkids.cps.ca or www.soinsdenosenfants.cps.ca.