Bendy Legs and Breastfeeding

Although we live in modern times, the past seems to be creeping into play more frequently lately. The BBC have had hits with their period drama Downton Abbey, and their portrayal of 1950’s life as a midwife with their adaptation of Jennifer Worth’s autobiography ‘Call the Midwife’. But it seems not all the representations portrayed in these and similar programmes are now purely the stuff of fiction.

Within the world of breastfeeding research, more and more concern seems to be focussed on Vitamin D deficiency, and the return of childhood problems such as rickets.

Vitamin D deficiency can be a serious problem, with low levels leading to ‘bendy legs’ (bowed legs in toddlers due to rickets), seizures, and developmental delay. And since breastmilk contains low levels of vitamin D, healthcare professionals, the media, and mothers are now questioning whether breastfeeding mothers should be administering vitamin D supplements.

In some countries – such as the U.S. – taking supplements as a matter of course seems to be the norm. In the U.K., however, its not really as clear cut. Although the National Institute for Health and Clinical Excellence (NICE) recommends that

‘pregnant and lactating women take a vitamin D supplement of 10 micrograms (or 400 units) daily and that health professionals inform all pregnant women about the importance of this for their health and the future health of their baby’ *

in reality, most healthcare professionals are unsure themselves as to whether mothers should be, or need to be, supplementing. Many breastfeeding mothers are also unsure whether or not they are at risk from low levels of vitamin D, and should be taking supplements.Taking too much vitamin D can also be a problem, as once you reach the level of toxicity (the exact amount of which depends on a variety of factors including age) there can be some serious side effects through hypercalcemia (the condition caused by too much vitamin D) which are just as bad as those caused by not having enough vitamin D.

The major reason why these old fashioned problems are creeping back into modern life is due to the lifestyle changes that have occurred during the latter part of the 20th century – covering up more, using total or high factor sunblocks, and increased migration (people with darker skins living in higher latitude environments which do not provide good enough levels of sunshine for the body to adequately synthesise the vitamin D it needs). Change in diet is another culprit – vitamin D rich foods such as fatty fish and fortified milk may be cut out of some mothers lives for various reasons.

However, if a mother has not had high enough levels of vitamin D in pregnancy, then taking supplements while breastfeeding will not really help, as the levels in breastmilk would still not be enough to compensate for the original low levels passed on to the developing baby in the womb. The human body was not designed to escalate vitamin D levels through digestion. Rather, the skin is the organ of the body which is primed to synthesise this vital ingredient of a healthy life.

Therefore, rather than supplementing whilst breastfeeding, mothers should be ensuring that they have a high enough level of vitamin D during pregnancy. This can be done the ‘traditional’ way, by being exposed to sunlight in moderation (a few minutes a day for those with fair skin, rising to around 20 minutes for those with darker skin). Or, if it’s Winter and there is no sun available, by taking vitamin D supplements whilst pregnant (following consultation with your healthcare professional).

If a mother is then worried having given birth that her baby has low levels of vitamin D, this can be partly remedied by vitamin supplements whilst breastfeeding, and then from the age of 6 months by giving the baby vitamin supplements directly (again, after taking advice from your healthcare professional). Or alternatively, you can boost vitamin D levels by allowing them a little exposure to the sun by getting out and about!

So, in conclusion – vitamin D for breastfeeding mothers = one more good reason for going to a buggy fitness group or having a picnic in the park with friends (and fatty fish!).

 

*taken from the Statement on Vitamin D Supplementation for Breastfed Babies by the UNICEF Baby Friendly Initiative – www.unicef.org.uk

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