I just wanted to comment that the post by Katherine West was very helpful in presenting salient points.

I had a couple of other questions that this whole issue raises:

1.  What is the bioavailabilty of Vitamin D in breastmilk?  My understanding that like other substances in breastmilk (iron), the levels may be "low" but one must also take into account the bioavailability may be greater than with other sources (eg cow milk formula).

2.  What impact does maternal prenatal vitamins have on Vitamin D levels in milk?  I advise the mother's in my practice to continue with their prenatal vitamins while they are nursing..

3.  While I was a medical student (in the eighties) I was in a clinical study at the University of Chicago-Pritzker that looked at ethnic differences in serum vitamin D levels.  The African Americans in the sample studied (including myself) had stastically significantly lower serum vitamin D levels than the Anglo counterparts (without showing clinical signs of Rickets).

Guess it is time for me to brush up on my nutrition pathology knowledge and read the journal article.

Pierrette Mimi Poinsett, MD FAAP
Modesto CA

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