Black, Breast-Fed Babies at Risk for Vitamin Deficiency
Supplements of vitamin D can prevent rickets, but the authors say giving vitamin D to mothers cannot raise the level of vitamin D in breast milk enough to prevent the condition. They therefore recommend giving vitamin D supplements in liquid form to babies at risk.
"We support breast-feeding as the ideal nutrition for babies and children but recommend supplementation of all dark-skinned, breast-fed infants and children with 400 IU of vitamin D per day, starting at least by two months of age," Kreiter and colleagues write.
Holick tells WebMD the study should not discourage black mothers or others with dark skin from breastfeeding.
"[Women] need to be aware of this minor issue and deal with it appropriately," he says.
Doctors can diagnose rickets by doing a blood test. Children who have confirmed rickets must be started on high doses of vitamin D immediately and continue to take the supplements for as long as they breast-feed. Holick says most babies will recover from rickets in three to six months, but some permanent damage, such as bowed legs, may require surgery. Once children start drinking whole milk they can usually stop taking the vitamin, but if they have milk allergies or reduced exposure to sunlight, it may be reasonable for them to take it for the rest of their lives, he says.
Robert P. Schwartz, MD, a co-author of the study, tells WebMD that all babies who are exclusively breast-feeding should be taking a daily multivitamin that contains the recommended daily amount of vitamin D needed to prevent rickets.