Thanks to Nancy for the update on the vitamin D and breast milk issue.
Supplementing all breastfed babies has been a hot topic at the recent US
Breastfeeding Committee and the Breastfeeding Promotion Consortium meetings
in Washington. During the Code monitoring project, NABA picked up the label
change on Mead Johnson products which are now all labeled as Enfamil,
including the vitamin D preparation (NABA's Code training workshop in May
will look at this). Mead Johnson is the only commercial source of vitamin D
for infants in the US. They recently added a coupon for $1.00 off their
vitamin D preparation in their hospital discharge bags for breastfeeding
mothers (NABA newsletter, Winter 2002). The accompanying text warns that,
"...While breast milk contains some vitamin D, there may not be enough for
your baby, depending on how much sun exposure your baby gets." WIC is already
purchasing and distributing this vitamin D in some states. What a bonanza for
Mead Johnson! I am still waiting for the proof that taking babies out in the
sun for short periods of time causes skin cancer. These recommendations are
being made based on a few cases not on a population basis.

The Institute of Medicine recommends sun exposure of 30 minutes per week for
a baby clad in a diaper or 2 hours fully clothed with no hat. That's about 4
minutes a day when its warm enough and 17 minutes a day for a nice walk
outside. Sunscreen is not supposed to be used on babies under 6 months of
age. So what do we tell mothers--keep your baby inside for 6 months and feed
him medication he can get by poking his little nose out the door? Nothing is
mentioned about maternal diet during pregnancy or lactation. Of what use is
this blanket recommendation?

Marsha Walker, RN, IBCLC
Weston, MA

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