Dear Dr. Joubert,

Your message was forwarded to the Lactnet list for a response.

I feel I must disagree with your first statement, that "vitamin D is
not found in sufficient amounts in breastmilk".  It is found in
sufficient amounts because if people lived as our ancestors, that is,
they took their babies outside occasionally, there is no need for
overly large amounts of vitamin D in breastmilk.  Nature should not be
held responsible for the perverse habits of people who are
"civilized".

Here are two references:

Roberst CC, Chan GM, Folland D, et al. Adequate bone mineralization in
breastfed infants. J Pediatr 1981;99:192-6

Specker BL, Valanis B, Hertzber V, et al. Sunshine exposure and serum
25-hydroxyvitamin D concentrations in exclusively breastfed infants. J
Pediatr 1985;107:372-6

Generally, if a baby will get adequate vitamin D stores during
pregnancy if the mother herself is vitamin D sufficient.  This is
rarely an issue in North America, as women gets lots of outside
exposure (maybe too much) and, in addition, most women also drink milk
which is enriched with vitamin D.  However, women who could be vitamin
D deficient may not pass on enough stores to the baby, and the baby
would then be at risk.  Such women are those who are veiled for many
years (a recent article suggested that 15% of Kuwaiti women are
vitamin D deficient, even though that country gets 700 days, easily,
of sunshine a year--but interestingly, not *all* veiled women in
Kuwait were vitamin D deficient).

Indirect sunshine through glass will not do the trick as the
ultraviolet radiation is filtered out.  On the other hand, direct
sunshine is not necessary, and even on cloudy days, ultraviolet gets
through.

Jack Newman, MD, FRCPC