"Some infants maybe hyper reactive to small doses of vitamin D.....vitamin D
toxicity is associated with hypercalcemia. In children, a single episode of
moderately severe hypercalcemia may arrest growth completely for 6 months or
more and the deficit in height may never be fully corrected."
http://www.dialforhealth.net/DIET/Toxicity_of_Vitamin_D.asp
According to another website:
"Excessive intake of Vitamin D leads to the development of hypercalcaemia and
its associated symptoms including hypercalciuria, ectopic calcification, and
renal and cardiovascular damage. Vitamin D should be administered with
caution to infants as they may have increased sensitivity to its effects..."
http://home.intekom.com/pharm/lennon/calcifer.html
"The first symptoms [vitamin D toxicity] are anorexia, nausea, and vomiting,
followed by polyuria, polydipsia, weakness, nervousness, and pruritus."
and "Kidney damage or metastatic calcifications, if present, may be
irreversible."
http://www.merck.com/mrkshared/mmanual/section1/chapter3/3e.jsp
The infant formula in Finland had 10 times the normal amount of vitamin D.
(400 IU/L standard in USA infant formulas) Depending on the extent of use of
these infant formulas, some babies may have health ramifications.
According to research by Pinto et al. in "Hypervitaminosis D: Report on
Three Patients," daily intake of as little as 1800 IU in children has been
reported to be toxic."
http://www.kfshrc.edu.sa/annals/183/97-178.html
Ten times 400 IU/L would put that at 4000 IU/L per day for an infant (not a
child). Thus, some infants maybe experiencing toxic reactions to these
specific infant formulas in Finland.
I think we should be aware of vitamin D toxicity with breastfed infants,
since the new AAP guidelines are recommending vitamin D drops for all infants from
birth. One of the cases described by Pinto et al. is a case where a
breastfeeding mother was overdosing on vitamin D which caused her infant to experience
vitamin D toxicity. (mother, who was a nurse, was prescribed vitamin d
during pregnancy, self-prescribed vitamin D for backache postpartum, infant was not
getting infant formula nor vitamin D drops).
Most women I worked with when I had a practice were taking prenatal vitamins
during the postpartum period (at least most said they were still taking their
prenatal vits) Has there been a consideration, research, regarding how this
might or might not impact vitamin D levels in breastfed infants? How easily
and correctly will dosages be given? Will mothers understand that more is not
better?
The amounts of vitamin D in human milk in the AAP new guideline for Vitamin D
intake are referenced to two studies. One study is written by Reeve LE,
Chesney RW, DeLuca HF, "Vitamin D of human milk: identification of biologically
active forms." DeLuca is probably the lead author. DeLuca owns many patents
on vitamin D and in fact owns a company called Deltanoid Pharmaceuticals.
This company has an agreement with Abbott Labs to develope 4th generation active
D therapies for renal disease. He is a professor at the University of
Wisconsin-Madison where alot of vitamin D research has been going on. Funding in
vitamin D research might have something to do with the belief that human milk is
"deficient in vitamin D." What companies manufacture vitamin D drops for
infants? Mead Johnson, Ross/Abbott, Gerber, Twinlabs, etc.
We seem to be using infant formula as the standard for amounts of vitamin D
the breastfed infant must maintain. The breastfed infant might receive 200 IU/L
vitamin D drops plus mom's prenatal vit D 200 IU/L. That would be 400 IU/L
equivalent to standard infant formula of 400 IU/L. Thus number wise breastfed
infants will at long last have equivalent intake to formula-fed infants.
Yet, I thought the principle was that human milk was the gold standard? With
this new guideline we seem to be trying to make human milk more like infant
formula. Yet the ironic thing is that the vitamin D content of infant formula
varies because of the degradation of the product during its shelf-life. And in
some cases obviously due to manufacturing error, there is too much vitamin D in
the product. We seem to be treating infant formula/cow's milk as the norm for
vitamin D supplementaion. Yet, the AAP new policy on breastfeeding states,
"Exclusive breastfeeding is the reference or normative model against which all
alternative feeding methods must be measured with regard to growth, health,
development, and all other short- and long-term outcomes." Exclusivity will not
exist with vitamin D supplements but at least on paper the breastfed infant
will finally get the same dosage of vitamin D that the formula fed infant gets.
Valerie W. McClain, breastfeeding advocate
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