I understand that North Carolina WIC will be providing Vitamin A,D, & C drops
to all exclusively breastfed infants beginning at 6 weeks of age.  This is a
result of ( if I understand the report) 17 cases of rickets in 1998 and 13
cases of rickets in the first 6 months of 1999.  All infants were African
American, mean age 14.9 months ( range 5 - 32 months) with average duration of
breastfeeding 12.5 months. It was reported that  the increase in cases was due
to the success in educating mothers about benefits of breastfeeding, decreased
sun exposure, mothers with lower educational levels may have less UV exposre,
maternal vitamin D status major factor in regulation of vitamin D in breast
milk, breastmilk contains 15-50 IU/1 compared to 400 IU/1 in formula, etc.
AAP Pediatric Nutrition Handbook states; " The vitamin D content in human milk
is low (11IU/1 and rickets can occur in deeply pigmented breastfed infants or
in those with inadequate exposure to sunlight. Consequently, vitamin D
supplementation at 400 IU/day is recommended for breastfed infants."
Therefor through a joint ( The Nurtition Services and Children and Youth
Branches of the North Carolina Department of Health and Human Services)
initiative will provideTri-Vi-Sol Viatmin A,D, & C drops free of charge to any
infant/child who is a resident of North Carolina, 6 weeks of age or older, and
exclusively breastfed.
I guess my question is ... why to all infants if there is has been an increase
in a small segment of the population? How will the addition of these
supplements affect the absorption of these vitamins and others that are
present in breastmilk?  What were the numbers of cases prior to 1998.   Are
cases of rickets high in other areas of the world where people don't get alot
of exposure to the sun or for religious reasons cover most of their bodies?
Are they routinely supplemented?  Who has the answers?

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