<<what I found disturbing is the following categories of people that
he
feels *do* need supplementation: pregnant and lactating women, the elderly,
and
**children who are breast-fed**(sic) About breastfed children Dr. Caballero
states: ".....should receive supplementation of vitamins A, C, and D, and
there is a preparation called Trivisol that is the standard issue to these
babies". >>
This is yet another case where the new AAP guidelines can come to our aid,
at least for the 1st 6 months. Here's the text, with supporting
references:
In the first 6 months, water, juice, and other foods are generally
unnecessary for breastfed infants.105,106 Vitamin D and iron may need to be
given before 6 months of age in selected groups of infants (vitamin D for
infants whose mothers are vitamin D-deficient or those infants not exposed
to adequate sunlight; iron for those who have low iron stores or
anemia).107-109 Fluoride should not be administered to infants during the
first 6 months after birth, whether they are breast- or formula-fed.
107. American Academy of Pediatrics, Committee on Fetus and Newborn, and
American College
of Obstetricians and Gynecologists. Maternal and newborn nutrition.
In: Guidelines for Perinatal Care. 4th ed. Washington, DC: ACOG,
AAP; 1997
108. Pisacane A, De Visia B, Valiante A, et al. Iron status in breast-fed
infants. J Pediatr.
1995;127:429-431
109. American Academy of Pediatrics, Committee on Nutrition. Vitamin and
mineral supplement
needs in normal children in the United States. Pediatrics.
1980;66:1015-1021
Diane Wiessinger, MS, IBCLC, LLLL Ithaca, NY
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