Recommended Vitamin D Intake for Breastfeeding Mothers
The recommended daily vitamin D intake for breastfeeding mothers is 10 mg/day (400 IU/day) to support vitamin D content in breast milk and reduce the risk of vitamin D deficiency in both mother and infant. 1
Evidence-Based Recommendations for Breastfeeding Mothers
- Multiple authoritative guidelines consistently recommend that breastfeeding women take a vitamin D supplement of 10 mg/day (400 IU/day) to ensure adequate vitamin D levels 1
- The National Institute for Health and Care Excellence (NICE) advises that all breastfeeding women, particularly teenagers and young women, take a supplement that meets 100% of the reference nutrient intake for their age group (10 mg/day or 400 IU/day) 1
- Public Health England specifically recommends that lactating women should take a vitamin D supplement of 10 mg/day to ensure they get enough vitamin D 1
- The Scientific Advisory Committee on Nutrition confirmed that these recommendations should remain unchanged since they were established in 1991 1
Impact on Infant Vitamin D Status
- Standard maternal supplementation of 400 IU/day increases maternal serum 25-hydroxyvitamin D (25OHD) levels but has limited effect on neonatal serum 25OHD levels of breastfed infants 1
- Breast milk vitamin D content reflects maternal vitamin D intake, but standard supplementation results in relatively low vitamin D transfer to breast milk 2
- The Institute of Medicine notes that maternal vitamin D intake only significantly affects neonatal serum 25OHD levels when maternal intake is extremely high (4,000-6,400 IU/day) 1
Higher Dose Considerations
- Some research suggests that higher maternal doses (up to 6,400 IU/day) can provide sufficient vitamin D in breast milk to maintain adequate infant vitamin D status without direct infant supplementation 2, 3
- A study showed that maternal supplementation with 6,000 IU/day safely optimized maternal vitamin D status and improved milk vitamin D content enough to maintain adequate infant serum 25OHD levels 3
- However, larger trials demonstrating the safety of high-dose cholecalciferol supplementation in lactating mothers are needed before universally adopting this strategy 1, 2
Safety Parameters
- The upper limit of vitamin D for all adults, including lactating women, is 100 mg/day (4,000 IU/day) 1
- Available data do not indicate a basis for deriving upper limits for vitamin D for lactating women that are different from their non-lactating counterparts 1
- Safety measurements in studies of higher-dose maternal supplementation, including serum calcium and urine calcium/creatinine ratios, have been similar to those with standard dosing 3
Current Practice Gaps
- Despite recommendations, vitamin D deficiency remains common worldwide among breastfed infants without adequate supplementation 2, 4
- Breast milk typically contains low levels of vitamin D, with studies showing that exclusively breastfed infants receive <20% of the daily recommended dose through breast milk alone 5
- The median daily intake of vitamin D through breast milk without supplementation is only about 77 IU/day, far below recommendations 5
Alternative Approaches
- For infants at high risk of vitamin D deficiency, direct infant supplementation with 400 IU/day may be more effective than maternal supplementation at standard doses 4
- In populations with high prevalence of vitamin D deficiency, maternal high-dose supplementation (≥4,000 IU/day) produced similar infant 25OHD levels as direct infant supplementation of 400 IU/day 4, 3
Common Pitfalls to Avoid
- Relying solely on dietary sources of vitamin D without supplementation is insufficient for breastfeeding mothers 2
- Assuming that standard maternal supplementation (400 IU/day) will provide adequate vitamin D in breast milk for infant needs without direct infant supplementation 2, 4, 5
- Failing to recognize seasonal variations in vitamin D status, which can affect both maternal and infant vitamin D levels 5