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Vitamin D

A breastfeeding mother sitting on a park bench

Vitamin D is needed to support healthy bone development and to prevent rickets, a condition that causes weak or deformed bones. Vitamin D deficiency rickets among breastfed infants is rare, but it can occur if an infant does not receive additional vitamin D from foods, a vitamin D supplement, or adequate exposure to sunlight.

Do infants get enough vitamin D from breast milk?

No. Breast milk alone does not provide infants with an adequate amount of vitamin D, even if mothers are taking vitamins containing vitamin D. Shortly after birth, most infants will need an additional source of vitamin D.

To avoid developing a vitamin D deficiency, the American Academy of Pediatrics recommends breastfed and partially breastfed infants be supplemented with 400 IU per day of vitamin D beginning in the first few days of life. Vitamin D supplementation should be continued unless the infant is weaned to at least 1 liter per day (about 1 quart per day) of vitamin D–fortified formula. Any infant who receives <1 liter or 1 quart of formula per day needs an alternative way to get 400 IU/day of vitamin D, such as through vitamin D supplementation.

Why are infants at risk for vitamin D deficiency?

The risk for vitamin D deficiency is increased when there is limited exposure to sunlight or when an infant is not consuming an adequate amount of vitamin D. Although reducing sun exposure is important for preventing cancer, it also decreases the amount of vitamin D that a person can make from sunlight.

To reduce the risk of skin cancer from sun exposure, the American Academy of Pediatrics recommends keeping infants younger than 6 months out of direct sunlight and protecting them with clothing and hats.

A mother giving a her baby a vitamin supplement

Other factors that decrease the amount of vitamin D a person can make from sunlight include:

  • Living at high latitudes (closer to the polar regions), particularly during winter months.
  • High levels of air pollution.
  • Dense cloud covering.
  • The degree to which clothing covers the skin.
  • Use of sunscreen.
  • Darker skin types.
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