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Vitamin D Information for Health Care Professionals

Vitamin D Supplementation for Exclusively Breastfed Infants
 
Recommendations
  • A daily vitamin D supplement of 400 IU is recommended for all breastfed, full-term infants in Canada.1
  • Supplementation should begin at birth and continue until 400 IU of vitamin D is provided from dietary sources or until 24 months of age for exclusively or partially breastfed infants/toddlers.2,3
  • Vitamin D supplementation amounts should be based on individual needs and recommended by a health care provider.
Rationale:
 
Exposure to sunlight is insufficient.
Sunlight is the principle source of vitamin D for humans. In Northwestern Ontario no vitamin D synthesis occurs between October and March. Furthermore, Health Canada recommend children under one year of age be kept out of direct sunlight.4 The use of sunscreen reduces vitamin D production.
 
Canadian Infants may be at risk of vitamin D deficiency.
Surveillance by the Canadian Pediatric Society indicates vitamin D deficiency has not been eradicated in Canada. The reasons include:
  • Not all breastfed infants receive vitamin D supplementation;
  • Maternal vitamin D insufficiency resulting in inadequate trans-placental vitamin D;
  • Northern latitude; and
  • Dark-skinned infants require increased exposure to sunlight to produce the same amount of vitamin D as light-skinned infants.5
Vitamin D content in breast milk
The vitamin D content of breast milk is low and is dependent on the vitamin D status of the mother. The vitamin D content of breast milk from vitamin D sufficient mothers is insufficient to meet the needs of infants beyond early infancy without adequate exposure to sunlight.6
 
Dietary Reference Intakes recommendation.
The Adequate Intake (AI) for infants 0 - 12 months is 200 IU. This is the maximum amount of vitamin D required to prevent deficiency. The Tolerable Upper Intake Level (UL) for infants up to 12 months is 1000 IU. This is the highest intake level at which no adverse effects occur. Daily supplementation with 800 IU of vitamin D can prevent deficiency, without risk of toxicity.
Health Canada recommends that all breastfed, healthy term infants receive a daily vitamin D supplement of 400 IU1. However, due to increased risk of vitamin D deficiency, babies living in Northwestern Ontario may benefit from a daily supplement of up to 800 IU.5
 
Learn more about:
 
Source:
1Health Canada. 2012. 'Vitamin D and Calcium: Updated Dietary Reference Intakes'. Retrieved from: www.hc-sc.gc.ca.
2Health Canada, Canadian Paediatric Society, Dietitians of Canada, and Breastfeeding Committee of Canada. 2012. 'Nutrition for Healthy Term Infants: Recommendations from Birth to Six Months.' Minister of Public Works and Government Services. Retrieved from: www.hc-sc.gc.ca.
3Health Canada, Canadian Paediatric Society, Dietitians of Canada, and Breastfeeding Committee of Canada. 2012. 'Nutrition for Healthy Term Infants: Recommendations from Six to 24 Months.' Minister of Public Works and Government Services. Retrieved from: www.hc-sc.gc.ca.
4Health Canada. 2013. 'Healthy Environments: What you can do!' 2013. Retrieved from: www.hc-sc.gc.ca.
5Canadian Pediatric Society. 2013. 'Position Statement - Vitamin D supplementation: Recommendations for Canadian mothers and infants'. Retrieved from: www.cps.ca.
6Dietitians of Canada. 2013. 'Vitamin D: What you need to know'. Retrieved from: www.dietitians.ca.