Below is a news release on a clinical report published in the April issue of
Pediatrics, the peer-reviewed, scientific journal of the American Academy of
Pediatrics (AAP).  To receive the full text of this report, please contact
AAP Public Relations.  The report will be posted on the AAP Web site on April
7 at http://www.aap.org

AAP REPORT: INFANTS NEED VITAMIN D SUPPLEMENTATION

CHICAGO - All healthy infants beginning during the first two months of life,
children and adolescents should receive vitamin D supplementation to prevent
rickets and vitamin D deficiency according to a new clinical report from the
American Academy of Pediatrics (AAP) entitled, "Prevention of Rickets and
Vitamin D Deficiency: New Guidelines for Vitamin D Intake."  The
recommendation includes breastfed infants.

According to the report, "It is recommended that all infants, including those
who are exclusively breastfed, have a minimum intake of 200 International
Units (IU) of vitamin D per day beginning during the first 2 months of life.
In addition, it is recommended that an intake of 200 IU of vitamin D per day
be continued throughout childhood and adolescence, because adequate sunlight
exposure is not easily determined for a given individual." This report
affirms guidelines from the National Academy of Sciences.

Public health officials are becoming increasingly concerned about continued
reports of infants who have been diagnosed with rickets, the bone-softening
disease caused by insufficient exposure to sunlight and inadequate vitamin D
intake. Unfortunately, an infant may be vitamin D-deficient long before being
diagnosed with rickets because the symptoms are not obvious.

Sunlight can be a major source of vitamin D, but sunlight exposure is
difficult to measure. Factors such as the amount of pigment in a baby's skin,
and skin exposure, affect how much vitamin D the body produces from sunlight.
Children should wear sunscreen when they are out in the sun. Sunscreen,
however, prevents the skin from making vitamin D.

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.

"This shouldn't discourage breastfeeding," said Nancy Krebs, M.D., FAAP,
chair of the AAP Committee on Nutrition. "The good news is that more babies
are being breastfed, and we need to be reminded what extra considerations
need to go with breastfeeding to best support the health of breastfed
infants."

Most bottle-fed babies, if they are drinking at least 500 ml (17 oz.) of
formula daily, should be able to get their daily requirements of vitamin D
from formula, as all infant formulas sold in the United States contain a
sufficient amount of vitamin D.

Vitamin D supplements, in drop or tablet form, are available over-the-counter
as part of multivitamin preparations.

[For an interview on this topic, contact Nancy Krebs, M.D., FAAP, at
303/315-7037, Lawrence Gartner, M.D., FAAP, at 760/751-9479 or Frank Greer,
M.D., FAAP at 608/262-6561.]

Dr. Gartner, Dr. Krebs and Dr. Greer tried to make it very clear that this is
NOT a breastmilk issue - it is a sunlight issue.  The statement that human
milk does not have enough Vitamin D is correct - it was never meant to!
Humans make most of their Vit D in response to sunlight.  Another example of
how culture/behavior changes faster than physiology.
Nancy
Nancy E. Wight MD, FAAP, IBCLC
Neonatologist, Children's Hospital, and Sharp Mary Birch Hospital for Women
Medical Director, Lactation Services, Sharp HealthCare
San Diego, CA, USA
Office: 858-541-4180
Fax: 858-541-4135
Pager: 858-493-0198
Email: [log in to unmask]

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