Dear Dr. Peralta,

I agree with Dr. Edlavitch that breastfed babies do not need vitamin D.  
I do not think either that the question should be controversial.

Why do babies who are not exposed much outside not need extra vitamin D?  
Because their mothers pass on sufficient stores to them while they are 
in utero.  Only if the mother herself is vitamin D deficient is there a 
concern.  It should be noted that sunlight on a sunny day is not 
necessary.  Even cloud covered days give you vitamin D if you are not 
covered.  Thus, muslim women who cover up and are veiled may become 
vitamin D deficient even in Saudi Arabia, which has abundant sunlight.  

Thus, vitamin D is only necessary for breastfed infants if it is thought 
that the mother herself was insufficient during the pregnancy.  Since, 
at least in Canada, most pregnant women are getting vitamin supplements, 
and most drink milk with added vitamin D, vitamin D deficiency in 
pregnant women is rare.

Why worry about it?  Why not just supplement every breastfed baby with 
vitamin D?  It is unlikely to be harmful.  Well, it is not completely 
harmless.  In Canada, a small bottle of vitamin D costs about $20 
Canadian ($15 US) and lasts a month.  Thus for a six month period of 
exclusive breastfeeding, the parents will pay $120.  This is not a lot 
of money for most new mothers, but it is for some, considering a recent 
study suggested 17% of Canadians live below the poverty line.  Thus, one 
of the big advantages of breastfeeding, that it is free, is gone, 
vanished into the profits of a formula company.  (Because vitamin D is 
made by the formula companies, isn't that just a strange coincidence?)  
The other is that it implies to the mother that her milk is deficient in 
some way.  Indeed, Mead Johnson has used this "necessity" to supplement 
vitamin to do more than imply the mother's milk is deficient.  One of 
its pamphlets states "With D-vi-sol and breastmilk, your baby's 
nutrition is now complete".  (The swines!!! A pox on them.)

I have been to Rio Gallegos, and I find it difficult to believe that you 
would consider it a sunlight deficient place.

Me gustó mucho el Argentina quand fue allá.  Hice el dedo desde las 
cataratas de Iguazú hasta Tierra del Fuego, desde Buenos Aires hasta 
Bariloche.  Que le vaya bien.

Jack Newman, MD, FRCPC