Dear all:

As always, one should not post when one is tired and in a hurry.  So, I
have a few corrections on the Sunlight deficiency post.

First, I want to make it clear that the formula industry was NOT AT THE
TABLE for the expert panel committee, nor the recommendation.  My source on
the industry involvement in the vitamins is not AT ALL related to the
expert committee. I received this information from someone else independent
of the expert committee panel. It is the post recommendation marketing and
pediatrician interpretation of the recommendations that has me concerned.
Perhaps it is more fair to say that this is another example of the
pharmaceutical industry as a whole taking advantage of a situation with an
inappropriate product, just like the contaminants in breast milk due to
environmental pollution (another real problem) enable the industry to make
women fearful of breastfeeding. What sparked my irritation was that the
pediatrician told a client that breast milk was deficient in vitamins A, D,
and C because this is what Trivisol contains.

Second, I want to reiterate that the PARENTS of children with rickets were
very upset that they weren't warned that this was a possibility. Ditto for
such deficiencies at vitamin B12 - which can occur in infants of vegan
moms.  This rare deficiency which does actually occur in the US and can
cause irreparable neurological damage and I feel we do have an obligation
not to make blanket statements that anything you eat is fine.  We need to
inform women in our breastfeeding classes about these possibilities.

Third, a piece I irresponsibly left out is that there is no vitamin D
conversion from sunlight in Boston from October to March!!!!! I don't know
about other latitudes.  We're not that far south here in Manhattan and have
lots of tall buildings, pollution, a cold snap that has us bundled up, so
this has me concerned.

Fourth, I should not have mentioned very perliminary, unverified reports on
rickets in New York. My point was that we can't be cavalier about this
because it does exist even in places where I would not have suspected it
and the fact that rickets is showing up in New York hospitals is relevant
to me since I live and work here.  The VERIFIED data that is out there is
that 5 per 1 million children in Georgia are hospitalized with rickets.  It
is suspected that the rates are higher among darker skinned infants.

Fifth, Remember that children hospitalized with rickets only the most
severe visible form of the deficiency.  As with any deficiency the more
subtle forms can cause damage and the presence of frank clinical deficiency
among hospitalized cases indicates that there is a more widespread problem
in the population.  Only 20% of children who have vitamin D deficiency are
hospitalized.

For the mom who I talked to - I did NOT make any recommendations either way
about what she should do - just presented her with what I understood and I
ALSO told her to go back to her pediatrician and discuss the issues with
her pediatrician, which I always think is a good idea.

Hope these clarifications make sense.  This is a tough issue with many
aspects and I've been having a hard time getting a good grasp of all the
details.

Best, Susan Burger

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