CHICAGO -- Doctors are recommending some new guidelines to avoid a disease they fear may be getting more common.
The American Academy of Pediatrics says all exclusively breast-fed infants should get vitamin D supplements to prevent rickets, a disease that weakens the bones. This is because human milk typically contains only small amounts of vitamin D, insufficient to prevent the disease.
In a statement published in the April issue of the journal
Pediatrics, the academy says breast-fed infants should get the supplements starting at 2 months of age, and until they start taking at least 17 ounces daily of milk fortified with vitamin D.
The report says: "It is recommended that all infants, including those who are exclusively breast-fed, have a minimum intake of 200 International Units (IU) of vitamin D per day beginning during the first 2 months of life. In addition, it is recommended that an intake of 200 IU of vitamin D per day be continued throughout childhood and adolescence, because adequate sunlight exposure is not easily determined for a given individual."
Sunlight can be a major source of vitamin D, but sunlight exposure is difficult to measure, according to the academy. Factors such as the amount of pigment in your baby's skin, and skin exposure, affect how much vitamin D the body produces from sunlight.
Children should wear sunscreen when they are out in the sun. But sunscreen hampers the skin's ability to make vitamin D.
Vitamin D supplements can be bought over the counter in liquid drops or tablets. Supplements that have only vitamin D are considered too strong to be safe for routine use.
Most bottle-fed babies, if they are drinking at least 17 ounces of formula daily, should be able to get their daily requirements of vitamin D from formula, as all infant formulas sold in the United States contain a sufficient amount of vitamin D.
"This shouldn't discourage breast-feeding," said Dr. Nancy Krebs, chairwoman of the AAP Committee on Nutrition. "The good news is that more babies are being breast-fed, and we need to be reminded what extra considerations need to go with breast-feeding to best support the health of breast-fed infants."
The new recommendation also applies to infants who aren't breast-fed but who don't drink at least 17 ounces of fortified formula or milk daily -- and to children who don't drink that much fortified milk, who don't get out in the sun much, and who don't already take multiple vitamins with at least 200 units of vitamin D.
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