Vitamin D drops for newborns?
with relevance for Vitamin D supplementation at any age
Today’s post is about Vitamin D supplementation for babies, with relevance for Vitamin D supplementation at any age.
Enjoy!
Babies are born equipped to absorb UV light much more rapidly than adults through two mechanisms:
Lower melanin levels, so they have less shielding
Higher vellus hair content (the super soft, uncolored hair or “peach fuzz”), which may absorb UV light approximately 250x as fast as normal hair
These physiological conditions seem to allow babies to meet their UV light requirements in a very short amount of time without experiencing dehydration, heat fatigue or sunburn
In un-supplemented individuals, solar-derived Vitamin D is thought to make up approximately 90% of serum levels1.
And yet it is common to find even highly educated researchers making claims such as “low compliance to Vitamin D daily supplementation” in breastfeeding mothers being a primary cause of low Vitamin D status in babies2.
Meanwhile, research published in 1985 from a US population estimated Vitamin D deficiency in infants under 6 months of age can be prevented through afternoon sunlight exposure in as little as 30 minutes per week3.
A recent review found that mothers were only taking their babies out for about 17 minutes per week4.
That’s potentially a needed increase of a mere +13 minutes per week for the average baby.
So why aren’t parents told about this?
Why use Vitamin D drops instead of sunlight?
It is disappointing that in this era of aggressive pharmacological supplementation and food fortification, natural interventions for attaining vitamin D sufficiency are ignored. Sunlight exposure may be advantageous as it may be safer (hypercalcemia perspective), more cost-effective, and offer additional benefits for mood elevation and development and maintenance of circadian rhythm, which is required for normal growth, steroid hormone secretion and sleep pattern.
R GOSWAMI AND HPS SACHDEV (2017)
Seasonal variation not accounted for in universal Vitamin D supplementation recommendations
Vitamin D research often fails to account for natural seasonal variation.
Whereas Vitamin D is a UV signal, there is another important molecule synthesized by the body and present in breastmilk that fulfills similar hormonal and antioxidant functions: melatonin.
Catch my quantum breastfeeding class for the importance of seasonal information communicated through breastmilk.
The reasons it is easier to prescribe Vitamin D drops than to prescribe sunshine
The exact amount of sunlight needed to synthesize significant amounts of Vitamin D depends on latitude, time of day, and individual differences.
Mainstream advice says to discuss this topic with your pediatrician. But most pediatricians aren’t educated about the salubrious effects of sunlight, only the potentially dangerous ones.
Thus, there isn’t a one-size-fits all sunshine recommendation for babies.
As always, this is meant to educate and inspire and help you fully understand what we know and what we don’t know so you can make the best decisions for your family.
Benefits of sunlight for babies beyond Vitamin D
First, we know that bringing babies outside has positive effects on baby’s immune health when outdoor time lands around 14 hours per week5 .
Fourteen hours per week is much higher than the estimated minimum needed for adequate Vitamin D status (which, remember, could be maintained at healthy levels in less than an hour per week, which most families may not be getting).
Other studies have also shown that 7-14 hours of weekly sunlight offers benefits Vitamin D supplementation alone does not for both babies and their mothers6
And as mentioned before, we also have evidence that a baby’s Vitamin D status is more strongly correlated with its exposure to sunlight than to its mother’s Vitamin D status7.
Furthermore, Vitamin D supplementation likely has no benefit for already sufficient babies8 (and we don’t routinely test a baby before adding supplements).
Given that the dietary Vitamin D pathway likely only accounts for 10% of serum levels anyways… many parents are beginning to question the recommendation for all babies to be supplemented.
The deeper significance of universal Vitamin D supplementation for babies is this:
It comes with the concurrent recommendation to deliberately keep babies out of direct sunlight for the first year of life.
The professional practice of telling mothers to keep babies out of direct sunlight simultaneously flaunts modern research, ancient tradition and expresses systemic distrust of mothers’ abilities to safely meter their baby’s time outside.
If you are wondering what the right choice for your family about balancing Vitamin D intake and solar exposure, you can review the information from this post with your pediatrician and come up with a plan for your family.
Evidence-based strategies for mothers who want to safely dose sunshine to support their babies Vitamin D levels and health
You may enjoy some of the posts I have created about sunlight strategies for new babies:
And consider the missing evidence and consideration of optimizing Vitamin K9 and magnesium10 intake and metabolism for babies, as both nutrients are needed for Vitamin D metabolism and may also be interfered with by exogenous Vitamin D administration.
Bae, Y. J., & Kratzsch, J. (2018). Vitamin D and calcium in the human breast milk. Best practice & research. Clinical endocrinology & metabolism, 32(1), 39–45. https://doi.org/10.1016/j.beem.2018.01.007
Corsello, A., Milani, G. P., Giannì, M. L., Dipasquale, V., Romano, C., & Agostoni, C. (2022). Different Vitamin D Supplementation Strategies in the First Years of Life: A Systematic Review. Healthcare (Basel, Switzerland), 10(6), 1023. https://doi.org/10.3390/healthcare10061023
Specker, B. L., Valanis, B., Hertzberg, V., Edwards, N., & Tsang, R. C. (1985). Sunshine exposure and serum 25-hydroxyvitamin D concentrations in exclusively breast-fed infants. The Journal of Pediatrics, 107(3), 372–376. https://doi.org/10.1016/S0022-3476(85)80509-6
Meena, P., Dabas, A., Shah, D., Malhotra, R. K., Madhu, S. V., & Gupta, P. (2017). Sunlight Exposure and Vitamin D Status in Breastfed Infants. Indian pediatrics, 54(2), 105–111. https://doi.org/10.1007/s13312-017-1010-9
Rueter, K., Jones, A. P., Siafarikas, A., Lim, E.-M., Bear, N., Noakes, P. S., Prescott, S. L., & Palmer, D. J. (2019). Direct infant UV light exposure is associated with eczema and immune development. Journal of Allergy and Clinical Immunology, 143(3), 1012-1020.e2. https://doi.org/10.1016/j.jaci.2018.08.037
Zhang, H., Liu, S., Si, Y., Zhang, S., Tian, Y., Liu, Y., Li, H., & Zhu, Z. (2019). Natural sunlight plus vitamin D supplementation ameliorate delayed early motor development in newborn infants from maternal perinatal depression. Journal of Affective Disorders, 257, 241–249. https://doi.org/10.1016/j.jad.2019.07.010
Haugen, J., Ulak, M., Chandyo, R., Henjum, S., Thorne-Lyman, A., Ueland, P., Midtun, Ø., Shrestha, P., & Strand, T. (2016). Low Prevalence of Vitamin D Insufficiency among Nepalese Infants Despite High Prevalence of Vitamin D Insufficiency among Their Mothers. Nutrients, 8(12), 825. https://doi.org/10.3390/nu8120825
Helve, Otto, Heli Viljakainen, Elisa Holmlund-Suila, Jenni Rosendahl, Helena Hauta-alus, Maria Enlund-Cerullo, Saara Valkama, et al. “Towards Evidence-Based Vitamin D Supplementation in Infants: Vitamin D Intervention in Infants (VIDI) — Study Design and Methods of a Randomised Controlled Double-Blinded Intervention Study.” BMC Pediatrics 17, no. 1 (December 2017): 91. https://doi.org/10.1186/s12887-017-0845-5
Masterjohn, C. (2007). Vitamin D toxicity redefined: Vitamin K and the molecular mechanism. Medical Hypotheses, 68(5), 1026–1034. https://doi.org/10.1016/j.mehy.2006.09.051
Reddy, P., & Edwards, L. R. (2019). Magnesium Supplementation in Vitamin D Deficiency. American Journal of Therapeutics, 26(1), e124–e132. https://doi.org/10.1097/MJT.0000000000000538