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Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 30 Mar 2003 23:36:51 EST
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In a message dated 3/30/2003 3:21:56 PM Pacific Standard Time,
[log in to unmask] writes:


> The AAP's recommendations for vit D supplementation of breastfed infants
> includes the inaccurate statement:
>
> Exclusively breastfed infants are at increased risk of vitamin D deficiency
> and rickets. This is because human milk typically contains only small
> amounts
> of vitamin D, insufficient to prevent rickets.
>

The statement is completely ACCURATE.  Babies make their own Vitamin D from
sunlight on their own skin.  It is extremely difficult to give mothers enough
Vitamin D (> 2,000 units per day) to increase the amount in their own
breastmilk. Having a mother out in the sun will not do it. Human milk was
never meant to have enough Vit D - babies were meant to make their own.

Although dark-skinned peoples are at the highest risk of rickets, there are
reported cases in those who, for religious reasons keep covered up, or those
who fear to go outside (as in inner city violent areas).  Virtually all the
cases were in exclusively breastfed infants.

I objected for years over the blanket recommendation that all breastfed
infants receive Vit D.  I felt it was just the AAP being "politically
correct" (but medically incorrect) by not singling out African-Americans.
The public health people, however, confirmed that an overall recommendation
is much more effective.  Rickets is a preventable disease.

The AAP has repeatedly asked drug companies to make a single Vit D 200 IU/ml
preparation, but so far they have not because they have other products they
wish to push, and their is no market at present.  The $$ talks.  Why do they
call them "Similac" or "Enfamil" multivitamins instead of Ross or Mead
Johnson? - clever marketing of course.

Although I still have objections to the AAP statement and approach, their
science is accurate.
Nancy
Nancy E. Wight MD, FAAP, IBCLC
Neonatologist, Children's Hospital & Sharp Mary Birch Hospital For Women
Medical Director, Sharp HealthCare Lactation Services
San Diego, California, USA
[log in to unmask]

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