Both the World Health Organization (WHO), as the Spanish Association of Pediatrics (Aeped) or the American Academy of Pediatrics (AAP) recommend breastfeeding for at least the first six months of life, being in turn in favor of breast milk as the best option for infant feeding. Then, after the introduction of solid foods, it is advised that breastfeeding continue during the first year of life, and if so desired, later.
This is because breast milk, due to its different properties for the newborn and its nutritional qualities, has a high concentration of both vitamins and minerals, as well as antioxidants and natural immunoglobulins that help protect the baby while their immune system and Your digestive system is still in development.
Therefore, as long as the baby is healthy and is being fed by a healthy mother, no supplementation with another nutritional or vitamin supplement is necessary. except in the case of vitamin D .
In fact, although there are different positions on whether it is appropriate to recommend or not the administration of this vitamin during breastfeeding, the AAP recommends its administration during the first 2 months of life (1), and then continue until after the first year of life if you continue breastfeeding, or until you start drinking a sufficient amount of formula milk enriched with vitamin D.
In this sense, the World Health Organization is clear: "Current data indicate that vitamin D supplements may be effective in preventing rickets, especially in children who are at increased risk of suffering from it due to their poor exposure to sunlight or because of dark complexion »(2). However, it does not specifically recommend its administration because more studies are needed.
However, leaving us a little closer, the Spanish Association of Pediatrics recommends supplementing the newborn with vitamin D from the first days of life, and keep it until, once weaning occurs, "the child already takes at least 1 liter milk diary of formula adapted enriched in vitamin D »(3). Similarly, those infants under one year who are fed formula milk but consume less than 1 liter daily should receive this supplement.
Regarding the amount of vitamin D advised, a supplement of 400 IU / day of vitamin D is recommended .
Why is vitamin D supplementation necessary during breastfeeding?
As stated by the Spanish Association of Pediatrics through its Breastfeeding Committee, it may seem strange that a baby that feeds on breast milk needs a vitamin supplement (in this case in particular, vitamin D).
The explanation - and its justification - is quite simple. And is that while it is true that breast milk is very complete nutritionally speaking (and ultimately is the best food for the baby for at least the first 6 months of life), The main source of vitamin D is sun exposure .
With the current lifestyle habits, it is common that nowadays the mother does not do so much outdoor activity with the little one, and if she does, she does it with sunscreens and clothes. Therefore, it is not possible that the mother's body may be able to synthesize enough vitamin D to cover the needs of her child. And this difficulty is even greater for dark-skinned people who have migrated to northern countries.
Therefore, it is absolutely normal - and in fact it is advisable - if your pediatrician has prescribed vitamin D supplementation during breastfeeding. In this way you can rest assured that your baby will receive the recommended amount of this vitamin, which is essential for the prevention of rickets .
The administration of 400 IU / day of vitamin D is recommended from the first years of life and its maintenance until after weaning. If the child after weaning does not take 1 liter daily of formula enriched with this vitamin, he should also receive the supplement with the same amount.
What is rickets and why is it so serious?
Rickets is a serious disease that causes the development of soft and weak bones in children , can produce symptoms such as sensitivity and pain in the bones, deformities in bones and teeth, and various growth problems (4).
It is a disease that arises when not enough vitamin D is received, as it is an essential vitamin for the bones still growing to be able to absorb minerals as fundamental as calcium or phosphorus. For this reason, it can not only occur due to a deficit of vitamin D, but also calcium and phosphorus.
- (1) Vitamin D Supplementation for Infants. AAP . 2010. Available at: https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Vitamin-D-Supplementation-for-Infants.aspx
- (2) Supplemental administration of vitamin D to the infant. WHO . 2015. Available at: http://www.who.int/elena/titles/vitamind_infants/es/
- (3) Frequently Asked Questions about Breastfeeding. Aeped . 2012. Available at: https://www.aeped.es/comite-lactancia-materna/preguntas-frecuentes-sobre-lactancia-materna
- (4) Rickets. MedlinePlus . 2018. Available at: https://medlineplus.gov/spanish/rickets.html
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