1. WHY VITAMIN D SUPPLEMENTATION MATTERS FOR BABIES?
Newborns are rarely taken out to a sunbath, and his/her vitamin D supplementation can only be obtained from breast milk or formula. If the mother has higher vitamin D levels, her breastfed baby would receive higher vitamin D levels through the breast milk. Formula milk is also designed to take the lack of vitamin D into consideration. In order to prevent the baby from having vitamin D deficiency, there are two things to be aware of: first of all, the mother must supplement sufficient vitamin D herself. Secondly, if the mother’s vitamin D level is low or the breastfeeding time is longer, giving the baby extra vitamin D supplementation is considered.
2. DOES BREAST MILK CONTAIN VITAMIN D? WHAT IS THE RECOMMENDED AMOUNT OF VITAMIN D INTAKE?
For babies, due to the diet limits, small amount of food intake, and lesser sun exposure, taking a supplement to achieve recommended levels of vitamin D intake is necessary. The average vitamin D content in breast milk is 22 IU/L (15-50 IU/L). Calculated by the average infant’s daily intake of 750 ml, the pure breastfeeding baby can only get about 11-38 IU/Day of vitamin D through the mother’s milk. It is far below the recommended intake of 400 IU/Day. Therefore, breastfed or semi-breastfed babies, and babies who are maladaptive to formula or complementary foods may generally have vitamin D deficiency. Taiwan Pediatrics Association recommended that exclusively breastfed or partially breastfed babies should be supplemented 400 IU of vitamin D daily. In addition, children who use formulas need to give 400 IU of vitamin D supplement per day if they consume less than 1,000 ml of vitamin D-rich formula or milk powder daily. In 2008, the American Academy of Pediatrics (AAP) recommended that all newborns to be supplemented with 400 IU per day right after birth, compared with the past, which is doubled the recommended dose to ensure that the daily needs of infants and young children are met.
3. WHEN SHOULD YOU STOP GIVING VITAMIN D TO YOUR BABY?
The American Academy of Pediatrics (AAP) recommended that exclusively breastfed or partially breastfed babies should be supplemented 400 IU of vitamin D daily.
4. AFTER STARTING COMPLEMENTARY FEEDING, DO BABIES STILL NEED TO SUPPLEMENT VITAMIN D?
After a baby reaches 6 months old, start try a variety of complementary foods, is adding vitamin D supplement still necessary? The answer is “YES”. Natural foods contain less vitamin D, in addition to liver, eggs and marine fish; however, the vitamin D content in liver, eggs and marine fish is actually not that high. One egg yolk is about 40 IU of vitamin D; eating 10 egg yolks would just reach the amount of 400 IU. Hence, having complementary food does not affect the baby to receive the supplemental vitamin D daily.
5. CAN YOU GET ENOUGH VITAMIN D FROM SUNLIGHT?
Vitamin D can be synthesized in the bare skin upon exposure to UVB rays from the sun. However, there are several problems: First, the American Academy of Pediatrics (AAP) recommends that babies within 6 months should not be exposed to sunlight directly. Because baby’s skin is very delicate; when expose to the sun improperly, it is easy to cause skin burns. Meanwhile, if the sun directly hit baby’s eyes, it is also easy to cause harm, the risk is high. For age more than 6 months, you need to pay attention to sun protection, such as avoiding strong UV rays, applying sunscreen, wearing long-sleeve trousers, and wearing wide-brimmed hats. Secondly, it is difficult to control the amount of vitamin D obtained from the sun; plus, the sun protection measures, air pollution, the sunshine intensity and other factors would all affect the effect. Therefore, although it is necessary for the baby to have proper outdoor activities to obtain certain amounts of vitamin D, it is not suggested to rely on the sun to supplement the vitamin D, in case of vitamin D deficiency.
6. WHAT ARE THE COMMON VITAMIN D PRODUCTS ON THE MARKET? HOW TO CHOOSE?
Liquid vitamin D products are best for infants and young children. Liquid products are easy to use and can be applied to mother’s nipples, pacifiers, spoons, or add into formulas and complementary foods. In terms of the formulas, it is essential to use oil that is easy to preserve, and use olive oil in some parts. However, in subtropical countries, the formulation of such base oil is easy to oxidized, produce bad oil odor and affect the product quality. The high viscosity characteristic of olive oil also tends to make it difficult to flow out of the dripper, not that ease-of-use.
Another common base oil is coconut oil, which is more stable than olive oil and is widely used due to the low cost. However, more than 50% of the main component of coconut oil is lauric acid, which is a long-chain fatty acid and has lower absorption rate.
The top base oil is medium chain triglyceride (MCT), a highly purified oil component of coconut oil that has been removed from lauric acid and other impure fats. Medium chain triglyceride (MCT) has the advantages of great stability, high absorption, good fluidity, not ease of oxidation and easy to preserve. It is the highest quality of oil formula for liquid vitamin D3.