Vitamin D in pregnancy & breastfeeding mothers: Is there really nothing healthy about a tan?

Vitamin D deficiency has become a major issue in Australia and could be due to our rigorous slip, slop and slapping. Vitamin D deficiency is of particular concern in pregnant women and breast-fed infants. It is estimated that rates of vitamin D deficiency are 18-84% amongst of pregnant women, varying from country to country. Vitamin D is an essential fat-soluble vitamin and is a key modulator of calcium metabolism in both adults and children (Mulligan et al. 2010).

During pregnancy, vitamin D is essential for the appropriate maternal response to increase calcium demands by the fetus as well as cellular differentiation and division. Adequate vitamin D may also help to prevent pre-eclampsia and hypertensive disorders, which complicate 3-10% of pregnancies. Vitamin D deficiency in infants and children can lead to malformation of bones such as rickets, osteomalacia as well as immune deregulation (Munns et al. 2006). An increasing number of studies show low levels of vitamin D are detrimental to health and testing individuals blood levels of 25-hydroxy vitamin D more common practice.

The largest determining factor of an infant’s vitamin D status is the maternal vitamin D levels. This is because the fetus acquires vitamin D via placental transfer in utero.  For this reason, all pregnant women should have vitamin D status evaluated in the first trimester of pregnancy or prior to conception if possible, to ensure adequate levels and to address deficiency early if required.

Human breast milk is the ideal food for babies, however it has very low levels of vitamin D. If the mother had adequate vitamin D during pregnancy, an infant will have enough stored for the first 8-12 weeks of life. Vitamin D can then be obtained by photosynthesis in the skin via sensible sun exposure. It is recommended that breast fed babies have a brief period of full body sun exposure before 10.00 and after 16.00 to obtain their daily requirement (Munns et al. 2006). Clothed, veiled or darker skinned babies may require longer exposure to ensure adequate levels. Vitamin D deficiency is less of an issue in formula fed babies as most formulas are fortified with the recommended daily amount of vitamin D.

Vitamin D can be obtained though dietary sources as well as via sun exposure once the infant commences solids. Natural sources of vitamin D3 include oily fish such as salmon, mackerel herring and cod liver oil. These fish have higher amounts of vitamin D3 if they are wild caught versus farmed. Wild salmon is said to have 500-1000IU of vitamin D3 per 100g compared to only 100-250IU from farmed salmon per 100g. Dairy products contain some vitamin D3, but amounts vary depending on the cows UVB sun exposure and health. Some foods such as yogurt, milk, cheeses and juices are fortified with vitamin D. If adequate intakes cannot be met though dietary intake or UVB exposure, supplementation maybe required (Holick & Chen 2008). It is best to seek the advise of a doctor or nutritionist to decide if supplementation is the best treatment and determine an appropriate dose.

References

Holick, MF & Chen, TC 2008, ‘Vitamin D deficiency : a worldwide problem with health’, vol. 87, pp. 1080–1086.

Mulligan, ML, Felton, SK, Riek, AE & Bernal-Mizrachi, C 2010, ‘Implications of vitamin D deficiency in pregnancy and lactation.’, Elsevier Inc., American journal of obstetrics and gynecology, vol. 202, no. 5, pp. 429.e1–9, viewed 5 March 2013, <http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3540805&tool=pmcentrez&rendertype=abstract>.

Munns, C, Zacharin, MR, Rodda, CP & et al 2006, ‘Prevention and treatment of infant and childhood vitamin D deficiency in Australia and New Zealand: a consensus statement’, Medical journal of Australia, 0, vol. 185, pp. 268–272, viewed 11 March 2013, <https://www.mja.com.au/journal/2006/185/5/prevention-and-treatment-infant-and-childhood-vitamin-d-deficiency-australia-and>.

Guest expert post by Brittany Darling, Nutritionist & Herbalist, BSc (NUT), ADV DIP (WHM), MATMS

www.wholefoodhealing.com.au

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About Katrina Zaslavsky

Katrina is an inspired international author, speaker and voice for women. A former public health professional turned mum on a mission and now editor, coach and practitioner, she is making positive waves across the globe as founder of Birth Goddess, committed to being a part of the “Positive Birth Revolution” and empowering women for motherhood.
Her book, A Modern Woman’s Guide to a Natural Empowering Birth, is a collection of inspiring birth stories (afterword by Dr Sarah Buckley MD) and shares how she overcame her extreme fears of childbirth and discovered inner peace and power she didn’t know she had. One of her biggest personal revelations that she would love to shout from every rooftop? “When birth is no longer feared, numbed or endured it has the opportunity to become one of the most powerful, positive and transformative things a woman will ever experience in her lifetime."

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