- Is Vitamin D Safe for Fertility, Pregnancy & Breastfeeding?
- Vitamin D Status & Reproductive Health
- Who is at Risk of Deficiency?
- Health Effects of Deficiency
- Safety & Potential Benefits of Supplementation
- Vitamin D & Breastfeeding
- May Improve Fertility in Men
- Vitamin D and fertility: can supplements help you conceive?
- What the expert says:
- Can vitamin D improve my IVF chances?
- Can vitamin D help reduce my fibroids?
- Can vitamin D regulate my menstrual cycle?
- Can vitamin D help with my PCOS?
- Are there other reasons for taking vitamin D supplements if I’m trying to get pregnant?
- If I’m taking vitamin D supplements, is it safe to take more than the recommended daily dose?
- Read more…
- Vitamin D and pregnancy: 9 things you need to know
- High Doses of Vitamin D May Cut Pregnancy Risks
- Nutrition Guide To Getting Pregnant While Breastfeeding | Theralogix Balanced Living Blog
- Critical Nutrients For Getting Pregnant While Breastfeeding
- Vitamin D For Fertility
- Vitamin D While Breastfeeding
- Vitamin D During Pregnancy
- Folate (folic acid)
- DHA (docosahexaenoic acid)
- If you become pregnant while breastfeeding, you may experience changes in breast milk
- Nutrition and Pregnancy
Is Vitamin D Safe for Fertility, Pregnancy & Breastfeeding?
If you’re pregnant or trying to conceive, nothing is more important than making sure you get the nutrients you need while avoiding any potentially harmful compounds.
But what about vitamin D? Is the “sunshine vitamin” safe? Can it improve fertility and support a healthy pregnancy? And should you worry about getting enough if you’re breastfeeding? Read on to get evidence-based answers to all these questions and more.
Vitamin D Status & Reproductive Health
Vitamin D or the “sunshine vitamin” is an essential fat-soluble vitamin.
The body naturally makes vitamin D when exposed to sunlight. Getting regular, moderate sun exposure is a safe way to maintain normal vitamin D levels during the summer months.
Vitamin D is also found in certain foods, such as fatty fish salmon and sardines. Additionally, many vitamin D supplements are available on the market.
The recommended daily intake of vitamin D for children above 1 year old and adults up to 70 years old is 600 IU. The recommended intake stays the same for pregnant and breastfeeding women. Newborns and babies require at last 400 IU/day until 12 months .
Remember to talk to your doctor before supplementing, especially if you are pregnant, breastfeeding, or trying to conceive!
- Required at 600 IU/day for general health
- Women with dark skin or wearing concealing clothes are at a greater risk of deficiency
- Some doctors may screen pregnant women at risk of deficiency
- Deficiency during pregnancy may impair bone health in both the mother and baby
- Most experts consider doses up to 4000 IU/day safe in vitamin D-deficient pregnancies
Who is at Risk of Deficiency?
According to some estimates, vitamin D deficiency was high in a diverse group of women during pregnancy, affecting 97% of African Americans, 81% of Hispanics, and 67% of Caucasians. Mothers with dark skin or wearing concealing clothes are at great risk of vitamin D deficiency [2, 3, 4].
Health Effects of Deficiency
Deficiency during pregnancy may affect both the mother and the baby.
Studies propose deficiency could lead to bone loss and osteomalacia in the mother. In newborns, it may cause impaired growth, bone, and enamel formation. Limited evidence suggests deficiency may also increase the risk of type 1 diabetes, asthma, and schizophrenia in newborns, though solid data are lacking to back up these findings [5, 6, 7, 8, 9].
A couple of studies have linked vitamin D deficiency during pregnancy with:
- An increased risk of preeclampsia, the leading cause of maternal and neonatal morbidity and mortality [10, 11].
- Almost 4 times the odds of primary cesarean section .
- Bacterial vaginosis, a highly prevalent vaginal infection that is associated with adverse pregnancy outcomes .
These findings are inconclusive. Additional studies with larger samples are needed to replicate them.
Additionally, some scientists think vitamin D sufficiency may protect from spontaneous preterm birth risk. More research is needed .
Safety & Potential Benefits of Supplementation
When doctors identify vitamin D deficiency during pregnancy, most agree that 1,000–2,000 IU per day of vitamin D is safe. Data on the safety of higher doses are lacking. Nonetheless, most experts at the American College of Obstetricians and Gynecologists consider doses up to 4000 IU/day safe in pregnant and breastfeeding women .
However, taking doses above 4000 IU/day can be harmful. Vitamin D supplements may also interact with prescription medications.
However, experts concluded that ongoing randomized clinical trials need to be completed to determine if vitamin D supplements (beyond that contained in prenatal vitamins) should be routinely recommended to pregnant women. Currently, evidence is lacking to recommend vitamin D supplementation for the prevention of preterm birth or preeclampsia .
Vitamin D & Breastfeeding
It was thought for decades that breast milk was naturally low in vitamin D.
Since vitamin D is transferred into the milk, the mother needs a daily source of vitamin D in order to provide her infant with enough substrate to avoid deficiency .
According to the latest recommendations, breastfeeding women need just 600 IU/day .
One study posited that breastfeeding women need to take in 6000 IU/day of vitamin D to provide their baby with the required amount of vitamin D (400 IU/day). Larger studies have yet to confirm this hypothesis .
Women who are not breastfeeding can provide their babies with vitamin D using a fortified formula .
May Improve Fertility in Men
Studies on mice show beneficial effects of vitamin D on the male reproductive system .
Male mice who lack vitamin D receptors suffer from infertility. Deficient mice had decreased sperm count and motility and structural abnormality of the testes [19, 20, 21, 22].
Scientists think that vitamin D is important for sperm production, growth, and survival .
The vitamin D receptor and the vitamin D metabolizing enzyme are present in the male reproductive tract including the testes, sperm, ejaculatory tract, and prostate [24, 25, 26, 27].
Limited studies have associated higher vitamin D blood levels with better sperm motility, which is an important fertility facto [28, 29].
In one study, men with vitamin D deficiency (blood levels
Vitamin D and fertility: can supplements help you conceive?
In a nutshell: There’s no conclusive scientific evidence that taking vitamin D supplements can help you get pregnant. However, there is some small-scale research suggesting that making sure you’re getting enough vitamin D may improve some conditions that can make getting pregnant more difficult, and may also increase the success of IVF treatment.
In addition, it’s now known that many women of reproductive age are deficient in vitamin D1 and that taking daily vitamin D supplement is both commonly recommended for general adult health2 and also strongly advised for anyone who is pregnant3. So, if you’re trying for a baby, it may well be worth considering taking a vitamin D supplement in preparation for pregnancy.
What the expert says:
We asked our expert GP Dr Philippa Kaye about vitamin D and conception. She said:
Vitamin D, by itself, won't help you conceive. But there is some evidence in both animal and human studies to suggest that vitamin D may affect fertility and IVF success rates Dr Philippa Kaye
Dr Kaye says the science isn’t strong enough to confirm a definite, causal link between having good levels of vitamin D and conception success. But she also points out that there is strong evidence that vitamin-D deficiency is associated with pregnancy complications (including gestational diabetes and pre-eclampsia4) – which is why pregnant women are advised to take vitamin-D supplements.
And, as vitamin-D insufficiency is really common in the UK, anyone planning to get pregnant may want to get a headstart.
Pregnant women are advised to take 10mcg vitamin D (400 UI) a day throughout the whole of pregnancy, so it may be worth starting while you are trying to conceive Dr Philippa Kaye
Can vitamin D improve my IVF chances?
Several observational studies have suggested that women seem to have a better IVF outcome when their vitamin-D levels are ‘sufficient’.
In 2018, a review of 11 of these studies,5 on 2700 women, confirmed these findings, saying “the chances of achieving a live birth, a positive pregnancy test and clinical pregnancy [after IVF] are higher in women who are vitamin-D replete when compared to those who are vitamin-D deficient or insufficient”.
The British scientists leading this review warned, however, that, though they’d found a link between good levels of vitamin D and successful IVF treatment, it was only an ‘association’ and clinical trials would have to be carried out before anyone could say that ‘correcting’ a woman’s vitamin-D levels before starting IVF would increase her chances of having a baby.
Can vitamin D help reduce my fibroids?
Fibroids – or, more correctly, uterine fibroids – are non-cancerous growths in your womb. They are quite common (affecting 1 in 3 women at some point in their life6) but often cause no symptoms at all.
However, if you have a large fibroid, it can make it difficult to get pregnant, as the fibroid may block 1 of your Fallopian tubes (through which your egg needs to travel to your womb) or prevent your fertilised egg attaching itself to the lining of your womb.
Dozens of small studies have suggested that vitamin D can inhibit the growth of fibroids. And in 2018 a review of 45 of these studies7concluded that “vitamin D and its analogues seem to be promising, effective, and low-cost compounds in the management of [fibroids] and their clinical symptoms”.
But again, the review authors state that more research is required before “vitamin D preparations can become the new tools in the fight with fibroids”.
Can vitamin D regulate my menstrual cycle?
If your periods are not regular, it can be more difficult to get pregnant7 because you might not ovulate (release an egg) regularly.
There are some studies8,9 that suggest a link between low levels of vitamin D and what researchers call ‘menstrual disorders’ but, again, further research has been called for.
Can vitamin D help with my PCOS?
Polycystic ovary syndrome – or PCOS – is a common condition that can affect ovulation and menstruation, and so make it difficult to get pregnant.
Among the studies into the role of vitamin D and menstrual cycles (see Can vitamin D regulate my menstrual cycle?, above), there are some observational studies that specifically focus on women with PCOS – with a range of results.
A 2015 overview10, published in the Indian Journal of Medical Research, says, “So far, the role of vitamin D polymorphisms on metabolic disturbances in women with PCOS remains inconclusive. Further investigations… are necessary.
Although it’s far from proved, then, that vitamin D supplements may help fertility issues caused by PCOS, we do have some anecdotal evidence from our MadeForMums Chat forum that they might.
Forum user Charchar27 says: “I was diagnosed with PCOS at 17, didn’t have my 1st period until I was 24 and between then and now (4 years later), I’ve had a total of 10 periods. My partner and I have never used any contraception: we took the view that it would never happen naturally.
A year ago, we started the process of getting fertility treatment but, for one reason or another, it kept getting put on hold. I started to do some research into natural supplements I could take and came across information about vitamin D and fertility. I thought, what harm could it do? I started taking them daily.
Lo and behold, 3 months later, I fell pregnant naturally! This could be a complete coincidence but, with how irregular I was, I really feel it played a part.”
Are there other reasons for taking vitamin D supplements if I’m trying to get pregnant?
It’s not proven, as we’ve seen, that taking vitamin D supplements will make it any easier or quicker for you to conceive. But, particularly in the winter months, they can do you good, in terms of your general health and many doctors, including Dr Philippa, do recommend taking them from September to March anyway.
And it won’t do you any harm (unless your GP advises that it’s specifically not recommended in your medical circumstances).
Why particularly in the winter months? Current NHS advice is that every adult needs 10 mcg vitamin D a day.
2 In the spring and summer, our bodies should be able to ‘make’ that much vitamin D naturally, as long as we eat a balanced diet and we’re outside long enough for our skin to absorb sufficient direct sunlight.
But, between September and March, when the sun isn’t so strong and we don’t go outside as much, our bodies may struggle to make that much vitamin D.
That’s why everyone in the UK is advised to consider taking a supplement of vitamin D between September and March2 – and people who have black or pigmented skin, who aren’t able to go outdoors or aren’t able (for cultural, medical or religious reasons) to uncover their skin outdoors are often advised to take a vitamin D supplement all year round.
Additionally – because low or deficient vitamin D have been shown to increase the risk of some pregnancy complications4 – women who are pregnant or breastfeeding are also advised to take a vitamin D supplement every day, regardless of the time of year.
If I’m taking vitamin D supplements, is it safe to take more than the recommended daily dose?
The recommended daily dose of 10mcg should be all that you need – although, if blood tests show you are very vitamin-D deficient, your GP may provide you with a large dose for a short period of time.
It’s important, though, not to take higher doses without medical supervision or for a long period of time. Taking too much vitamin D can cause too much calcium to build up in your body (a condition called hypercalcaemia)2. This can weaken your bones and damage your kidneys and heart.
Dr Philippa Kaye works as a GP in both NHS and private practice.
She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.
1 Vitamin D Insufficiency Among Free Living Healthy Young Adults. Tangpricha V et al. The American Journal of Medicine. Volume 112, Issue 8, Pages 659–662. DOI: https://doi.org/10.1016/S0002-9343(02)01091-4
2. Vitamin D: NHS online
3. Vitamins, supplements and nutrition in pregnancy: NHS online
Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. Aghajafari F et al. BMJ 2013 Mar 26;346:f1169. doi: 10.1136/bmj.f1169.
5. Vitamin D and assisted reproductive treatment outcome: a systematic review and meta-analysis. Chu, J.
Human Reproduction, Volume 33, Issue 1, January 2018, Pages 65–80, https://doi.org/10.1093/humrep/dex326
6. Fibroids: overview. NHS online
7. Vitamin D and Uterine Fibroids — Review of the Literature and Novel Concepts Ciebiera M et al. International Journal of Molecular Sciences. DOI: 10.3390/ijms19072051
The Relationship between Vitamin D Status and the Menstrual Cycle in Young Women: A Preliminary Study Łagowska, K. Nutrients 2018. DOI: 10.3390/nu10111729
9. Lower plasma 25-hydroxyvitamin D is associated with irregular menstrual cycles in a cross-sectional study. Jukic, AM et al. Reproductive Biology and Endocrinology 2015; 13:20. doi: 10.1186/s12958-015-0012-5
The role of vitamin D in polycystic ovary syndrome. Lin MW et al. Indian Journal of Medical Research 2015 Sep; 142(3):238-240. doi: 10.4103/0971-5916.166527
Vitamin D and pregnancy: 9 things you need to know
With all the publicity surrounding vitamin D lately, it’s no surprise that you have lots of questions. Should you test your patients for deficiency? When? What numbers should you use? And how do you treat a low vitamin D level?
In pregnancy, these issues become critical because there are not one but two patients to consider. Despite the lack of clear guidelines, there is sufficient evidence to suggest that you should at least consider monitoring the vitamin D status of your pregnant patients.
Fetal needs for vitamin D increase during the latter half of pregnancy, when bone growth and ossification are most prominent. Vitamin D travels to the fetus by passive transfer, and the fetus is entirely dependent on maternal stores.1 Therefore, maternal status is a direct reflection of fetal nutritional status.
The vitamin D level in breast milk also correlates with the maternal serum level, and a low vitamin D level in breast milk can exert a harmful effect on a newborn.
In this article, I address nine questions regarding vitamin D and pregnancy:
- Is vitamin D really a vitamin?
- Why do the numbers vary?
- Does the vitamin D level affect pregnancy outcomes?
- Can’t people get enough vitamin D through their diet?
- What level signals deficiency?
- How many women are deficient?
- Should you test all pregnant patients?
- How should you treat vitamin D deficiency in pregnancy?
- Can a person get too much vitamin D?
For years, vitamin D was discussed solely in relation to bone metabolism and absorption, and deficiency states were the purview of endocrinologists and gynecologists who treated menopausal patients at risk of osteoporosis.
Recent studies demonstrate that vitamin D plays a role in multiple endocrine systems. Indeed, vitamin D may be more correctly considered a hormone because it is a substance produced by one organ (skin) that travels through the bloodstream to target end organs.
Vitamin D receptors have been found in bone, breast, brain, colon, muscle, and pancreatic tissues. Not only does vitamin D affect bone metabolism, it also modulates immune responses and even glucose metabolism.
2 Vitamin D receptors have also been found in the placenta; their role in that organ remains to be elucidated.
Some of the confusion surrounding vitamin D concerns the units used to measure and discuss it. Vitamin D can be measured in nanograms per milliliter (ng/mL) or in nanomoles per liter (nmol/L). A measurement of 1 ng/mL equals approximately 2.
44 nmol/L. Therefore, deficiency in some articles is described as a vitamin D level below 20 ng/mL and in other articles as a level below 50 nmol/L. As for normal range, it may be listed as a level above 32 ng/mL or as a level above 75 nmol/L.
Compounding the confusion, vitamin D in supplement form can be written in two different measurements—using micrograms or international units. A measurement of 1 μg equals 40 IU, so a supplement of 150 μg/day is the same as one of 6,000 IU/day.
Vitamin D’s role in pregnancy outcomes has yet to be fully described, making it an exciting field to explore.
Research into vitamin D and its effects on pregnancy is still in its infancy, but many intriguing associations have been noted.
For example, lower levels of vitamin D have been associated with increased rates of cesarean delivery,3 bacterial vaginosis,4 and preeclampsia,5 as well as less efficient glucose metabolism.6
There is biological plausibility for vitamin D to play a role in pregnancy outcomes, given the presence of receptors in gestational tissues. Vitamin D receptors in uterine muscle could affect contractile strength, and vitamin D has been shown to have immunomodulatory effects, thereby potentially protecting the host from infection.
As I mentioned, placental vitamin D receptors and their role need further exploration.
Very few foods contain a large amount of vitamin D, and the few that do (herring, cod liver oil) are not standard fare. Even fortified foods such as milk lack a substantial amount. TABLE 1 lists the amount of vitamin D in various foods.7
|Cereal, fortified with vitamin D, 1 cup||40–50|
|Cow’s milk, fortified with vitamin D, 8 oz||98|
|Soy milk, fortified with vitamin D, 8 oz||100|
|Orange juice, fortified with vitamin D, 8 oz||100|
|Quaker Nutrition for Women instant oatmeal, 1 packet||154|
|Tuna, canned in oil, 3 oz||200|
|Sardines, canned, 3 oz||231|
|Mackerel, 3 oz||306|
|Tri-Vi-Sol infant supplements, 1 drop||400|
|Catfish, 3 oz||425|
|Pink salmon, canned, 3 oz||530|
|Cod liver oil, 1 tablespoon||1,360|
|Herring, 3 oz||1,383|
|Over-the-counter vitamin D3 supplements||2,000 (maximum)|
|Typical prescription of vitamin D2 for deficiency||50,000 (given weekly until replete)|
High Doses of Vitamin D May Cut Pregnancy Risks
From the WebMD Archives
May 4, 2010 — Women who take high doses of vitamin D during pregnancy have a greatly reduced risk of complications, including gestational diabetes, preterm birth, and infection, new research suggests.
the findings, study researchers are recommending that pregnant women take 4,000 international units (IU) of vitamin D every day — at least 10 times the amount recommended by various health groups.
Women in the study who took 4,000 IU of the vitamin daily in their second and third trimesters showed no evidence of harm, but they had half the rate of pregnancy-related complications as women who took 400 IU of vitamin D every day, says neonatologist and study co-researcher Carol L. Wagner, MD, of the Medical University of South Carolina.
Wagner acknowledges the recommendation may be controversial because very high doses of vitamin D have long been believed to cause birth defects.
“Any doctor who hasn't followed the literature may be wary of telling their patients to take 4,000 IU of vitamin D,” she says. “But there is no evidence that vitamin D supplementation is toxic, even at levels above 10,000 IU.”
Most prenatal vitamins have around 400 IU of vitamin D, and most health groups recommend taking no more than 2,000 IU of the vitamin in supplement form daily. Wagner says it took months to get permission to do a study in which pregnant women were given doses of the vitamin that were twice as high as this.
The study included about 500 women in Charleston, S.C., who were in their third or fourth months of pregnancy. The women took 400 IU, 2,000 IU, or 4,000 IU of vitamin D daily until they delivered.
Not surprisingly, women who took the highest doses of vitamin D were the least ly to have deficient or insufficient blood levels of the vitamin, as were their babies.
These women also had the lowest rate of pregnancy-related complications.
Compared to women who took 400 IU of vitamin D daily, those who took 4,000 IU were half as ly to develop gestational diabetes, pregnancy-related high blood pressure, or preeclampsia, Wagner says. They were also less ly to give birth prematurely.
The research was presented over the weekend at the annual meeting of the Pediatric Academic Societies in Vancouver, British Columbia.
Infants with very low vitamin D levels are at increased risk for soft bones, or rickets — a condition that is now rare in the U.S.
But over the last decade, more and more studies suggest that vitamin D also protects against immune system disorders and other diseases, Wagner says.
Fortified milk and fatty fish are common food sources of vitamin D, but most people get only a small fraction of the vitamin D they need through food, Wagner says. Instead, the body makes vitamin D from sunlight.
But even in sunny climates Charleston, few people are now getting adequate levels of vitamin D from sun exposure.
At the start of the study, deficient or insufficient levels of vitamin D were seen in 94% of the African-American women, 66% of Hispanic women, and 50% of white women who participated.
University of Rochester professor of pediatrics Ruth Lawrence, MD, has been recording vitamin D levels in new mothers and their infants for three years. She did not take part in the new study.
Lawrence, who chairs the breastfeeding committee of the American Academy of Pediatrics, says exclusively breastfed babies whose mothers have low vitamin D levels and who don't take vitamin supplements are most ly to be deficient.
“It is clear that both for mothers and their babies, vitamin D levels are low,” she tells WebMD. “This is true in northern areas Rochester and in sunny climates Charleston.”
Lawrence sees no problem with the recommendation that women take 4,000 IU of vitamin D daily during pregnancy, although she says the impact of high doses of vitamin D on pregnancy-related complications remains to be proven.
“Four thousand IU may sound outrageous to some, but I believe it is really not unreasonable,” she says.
“We have been searching for the causes of preeclampsia and premature birth for many years. It is reassuring that the risk of these complications are lower for women taking extra vitamin D, but it is premature to say it is the cause.”
The independent health policy group the Institute of Medicine recommends 200 IU to 400 IU of vitamin D a day for everyone, including pregnant women, but this recommendation is under review. Revised guidelines are expected late this summer.
Pediatric Academic Societies annual meeting, Vancouver, British Columbia, May 1-4, 2010.
Carol L. Wagner, MD, neonatologist and pediatric researcher, Medical University of South Carolina, Charleston.
Ruth Lawrence, MD, professor of pediatrics, University of Rochester School of Medicine, New York.
News release, American Academy of Pediatrics.
© 2010 WebMD, LLC. All rights reserved.
Nutrition Guide To Getting Pregnant While Breastfeeding | Theralogix Balanced Living Blog
If you are thinking about getting pregnant while breastfeeding, you may have some important nutrition questions. On the one hand, you need to feed your growing baby. On the other, you want to optimize your fertility and improve your chances. Read on for our nutrition guide to getting pregnant while breastfeeding.
Critical Nutrients For Getting Pregnant While Breastfeeding
The Centers for Disease Control and Prevention issued Healthy People 2020 Objectives which set goals to increase the proportion of breastfeeding newborns.
The good news is that breastfeeding is on the rise! Breast milk is optimal nutrition for your baby. It is not necessary to stop nursing while trying to conceive.
Once you conceive, you may experience some changes in your breast milk, but this should not affect its healthfulness.
It is important to maintain optimal nutrition for both fertility and nursing. How can you be sure you get the nutrients you need to support nursing and to prepare you for pregnancy?
Vitamin D For Fertility
Your vitamin D level is critical when thinking about conceiving. For women trying to conceive naturally, those with higher vitamin D levels have better odds of conception.
There are a number of studies looking at the effects of vitamin D among women going through fertility treatment. Many studies link normal vitamin D levels with higher pregnancy rates and maintaining a healthy pregnancy.
Vitamin D supplements are beneficial for fertility and are also considered safe to continue during pregnancy and nursing.
Vitamin D While Breastfeeding
During nursing, vitamin D is important for your baby’s overall growth and development. For most women, breast milk doesn’t contain the amount of vitamin D recommended for their baby.
The American Academy of Pediatrics recommends giving babies who are exclusively nursing 10 mcg (400 IU) of infant vitamin D drops each day. But for many moms, giving vitamin D drops is difficult since some babies don’t the taste.
In fact, research has shown that less than 20% of nursing moms give their baby vitamin D drops each day. Because of this low compliance rate, many nursing babies run the risk of vitamin D deficiency.
A more recent study asked breastfeeding moms about vitamin D supplementation. Surprisingly, over 85% reported that, rather than give the baby drops, they would prefer to take a vitamin D supplement themselves.
A study by Dr. Bruce Hollis helps us answer the question of how much vitamin D is needed while nursing. In this study, mothers took 160 mcg (6,400 IU) of vitamin D daily. Their infants achieved the same vitamin D blood level as those given 10 mcg (400 IU) daily by dropper. So, these babies received enough vitamin D through breast milk alone.
As your baby is introduced to solid foods, you can begin to take less vitamin D. At this stage, your breast milk is not the sole source of food for your baby. Your nursing child should be able to get enough vitamin D from your breast milk and solid foods rich in vitamin D such as eggs and fortified cereals.
Vitamin D During Pregnancy
If you get pregnant while breastfeeding, you can take up to 100 mcg (4,000 IU) of vitamin D each day. This dose will meet both your nursing baby and your needs while pregnant. Research shows that 4,000 IU of vitamin D is safe and effective for achieving a normal vitamin D level during pregnancy.
Folate (folic acid)
Folate (folic acid) helps with many of the body’s normal processes. However, the most well-known benefit is that folic acid prevents birth defects of the baby’s brain and spine. These birth defects are known as neural tube defects (NTDs).
The neural tube starts out as a tube- grouping of cells inside the embryo. It finishes forming 4 to 6 weeks after the first day of a woman’s last menstrual period. Studies have shown that taking at least 667 mcg DFE (400 mcg of folic acid) for at least one month before conception, and continuing through pregnancy, can significantly reduce the risk of NTDs.
Since your nursing baby relies on the nutrients your milk supplies, health experts often recommend a supplement to supply enough folate (folic acid) every day to support lactation.
Choline is important while trying to conceive and during pregnancy and lactation. This nutrient is a vitamin- compound that supplies building blocks for other compounds in the body. It has many roles including cell membrane signaling and lipid transport.
It is important to get enough choline while trying to conceive. Choline works along with folate in neural tube formation.
Although your body can make small amounts of choline, it can’t make enough to meet your needs. During pregnancy, these needs increase to 450 mg and go up to 550 mg during lactation.
Your requirement for choline is higher during lactation than at any other time during your life. Despite choline’s importance, few women get enough in their diet. National survey results show that only 6% of women in the U.S. meet the recommended amount of choline each day.
To get enough, eat foods rich in choline. In most cases, you will also need to take a supplement to get the amount your body requires. It is worthwhile to also structure your meals by choosing choline-rich foods. Here is a list to help you plan meals to get adequate choline through your diet in addition to a choline supplement.
DHA (docosahexaenoic acid)
DHA is an omega-3 fatty acid connected to brain, vision and nervous system development, and it’s important for your nursing baby. It accumulates rapidly in the baby’s brain starting during the second trimester of pregnancy and continuing until age 2.
The amount of DHA in your breast milk depends on the amount of DHA you get in your diet or through supplements. Most health experts recommend a supplement containing at least 200 mg DHA during lactation.
Studies show that DHA supplied through breastmilk may increase your baby’s DHA level better than giving DHA directly to your baby.
If you become pregnant while breastfeeding, you may experience changes in breast milk
Between the fourth and eighth month of pregnancy, breast milk will usually change over to colostrum in anticipation of birth. It’s fine for an older child who is nursing to consume colostrum.
However, be aware that colostrum has a natural laxative effect. Your older child may experience more frequent, looser stools.
The colostrum will be present until the baby is born and the colostrum usually changes over to mature milk three to four days after birth.
If you are considering getting pregnant while breastfeeding, you can meet your unique nutrient needs by choosing a prenatal vitamin that supplies folic acid (folate), vitamin D, choline, and DHA.
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Nutrition and Pregnancy
Your nutritional choices before, during, and after pregnancy have a major impact on the long-term health of both you and your baby. Prepare for a healthy pregnancy by eating a balanced diet, taking a high-quality prenatal supplement, and maintaining an overall healthy lifestyle including regular physical activity.
BEFORE YOU GET PREGNANT
It’s never too soon to begin preparing for your baby.
As soon as you are actively trying to get pregnant, start taking a prenatal supplement that provides a complete range of nutrients including extra folic acid, choline, and vitamin D.
Folic acid and choline are important for the early development of a baby’s nervous system, which occurs in the first few weeks of pregnancy, often before a woman knows that she is pregnant. Maintenance of a normal vitamin D level is also important for a healthy pregnancy.
For women over 35, taking a supplement containing coenzyme Q10 (CoQ10) may be beneficial for healthy ovarian function. Research indicates that CoQ10 may support mitochondrial energy production in the ovary for improved egg quality in women age 35 and older.
EATING RIGHT DURING PREGNANCY
In addition to taking a high-quality prenatal multivitamin and mineral supplement, mothers-to-be need to east a variety of healthful foods every day.
A balanced diet to support your healthy pregnancy consists of colorful fruits and vegetables, whole grains (whole grain bread and pasta, brown rice, quinoa, couscous), lean protein (milk beans, tofu, and lean meats and poultry), and healthful fats (olive oil, walnuts, almonds, avocados).
AN OVERALL HEALTHY LIFESTYLE DURING PREGNANCY AND BEYOND
A lifestyle that includes healthy eating habits, regular physical activity, and refraining from smoking, excessive alcohol consumption, and substance abuse will support the lifelong health of your entire family. Remember, when a child reaches adulthood, they tend to eat what their parents at, and follow the lifestyle patters they learned early in life. So making good choices now can influence your child to lead a health lifestyle into adulthood.
Most women can be moderately physically active throughout their pregnancy. In fact, a fit woman may experience an easier labor and faster recovery due to her strength and endurance. Talk to your doctor to see if you need to make any modifications to your exercise program.
KEY NUTRIENTS FOR PREGNANCY
There are many different prenatal supplements on the market. It is important to find one that is easy for you to swallow, and that you tolerate well. A high-quality prenatal should generally contain the following nutrients.
Optimal vitamin D levels are important for a healthy pregnancy
Low vitamin D blood levels are common among pregnant women and have been associated with numerous complications of pregnancy.
Low intake of vitamin D during pregnancy has also been associated with low infant birth weights and increased risk of childhood asthma. Typical prenatals provide 400 IUI of vitamin D, which recent research suggests is inadequate.
For example, one study showed that even with 800 IUI of vitamin D per day, most pregnant women and their infants did not achieve a normal vitamin D level.
Recent studies tested 2000 and 4000 IUI of vitamin D per day in pregnant women. The researchers found these doses were safe and effective in achieving normal vitamin D levels.
Pregnancy complications such as preterm labor and infection were lower in women with higher vitamin D levels at delivery.
Look for a prenatal with 2000 to 4000 IUI vitamin D3, the preferred from of vitamin D, per daily dose.
Folic acid is critical during the first trimester to reduce the risk of neural tube birth defects.
Choline is important to promote your baby’s brain development.
Vitamin B6 (pyridoxine) may help reduce nausea during pregnancy.
Iodine promotes normal thyroid function and nerve and brain development.
Increased iron is recommended to meet your increased needs during pregnancy.
Biotin is broken down more rapidly during pregnancy.
DHA (docosahexaenoic acid) is beneficial for your baby’s brain and visual development)
UNIQUE NUTRIENT NEEDS FOR LACTATION
Breastfeeding is one of the best things you can do to support your baby’s health, and good nutrition plays a key role in your baby’s growth and development.
Moms who breastfeed have unique nutrient needs — different from during pregnancy or any other time in a woman’s life.
Taking a nutritional supplement specifically formulated for breastfeeding moms, along with a balanced diet, will provide the essential vitamins and minerals needed during this time.
Vitamins A and C
While you are breastfeeding, you need slightly more vitamins A and C than most prenatal supplements provide. Higher amounts of these vitamins are needed for yor breast milk to meet your baby’s nutritional requirements. Look for a lactations supplement that contains the Recommended Daily Allowance for vitamin A (4000 IUI) and vitamin C (120 mg)
Your requirement for choline, a nutrient that supports your baby’s growth and brain development, is higher during lactation than at any other time during your life.
This nutrient is often left prenatal supplements because it is bulky; however, it is estimated that only 10% of American meet their daily choline needs. Foods rich in choline include egg yolks, Brussels sprouts and broccoli, milk and some meats.
Look for a lactation supplement with 200 -300 mg of choline to help meet the recommended amount for breastfeeding mothers (550 mcg)
DHA is beneficial for your baby’s brain and visual development. The omega-3 fatty acid DHA is important during pregnancy and lactation because of its role in infant brain and eye development.
The amount of DHA in your breast milk is directly related to the amount of DHA in your diet (from fatty fish such as wild caught salmon) and your supplements, so it is important to get enough while you are breastfeeding.
Look for a lactation supplement with 300 mg DHA.
Vitamin D is important for your baby’s overall growth and development. The American Academy of Pediatrics recommends that breastfed infants receive 400 IU vitamin D drops each day to prevent vitamin D deficiency and rickets.
This is because most women don’t have enough Vitamin D in their breast milk. It is important that babies get enough, but not too much, of this important nutrient. Early research suggests that if mothers take very high doses of vitamin D, there may be enough in breast milk.
However, it is not yet clear exactly how much vitamin D is needed. Until the exact amount is known, a lactations supplement should contain about 1000 IUI of vitamin D3 to support your nutrient needs without providing too much to your baby.
Talk to your pediatrician if you have questions about vitamin D for you and your baby.
Although you needed more folic acid in early pregnancy to support your baby’s growth and neural tube development, your folic acid needs are lower during lactation.
There is some controversy about supplementing with high doses of folic acid for long periods of time, so it makes sense to take higher doses only before and ruing pregnancy, when it is really needed.
Look for a lactation supplement with 400-600 mcg of folic acid.
Your iron needs are much lower while breastfeeding than during pregnancy. If you are breastfeeding exclusively, you ly will not have your period for 4 to 6 months after giving birth.
Without menstrual blood loss each month, your iron needs decrease. If you are anemic after giving birth, however, you may need additional iron supplementation.
Look for a lactation supplement with 9 mg of iron, the Recommended Daily Allowance during breastfeeding.
MORE INFORMATION ABOUT VITAMIN D AND PREGNANCY
Recent studies indicate that low vitamin D levels are common among pregnant women in the US and in the UK, even among those taking a standard prenatal multivitamin, which usually contains 400 IUI.
Low vitamin D levels during pregnancy can affect the well-being of the mother as well as the newborn. Adequate vitamin D during pregnancy is important for skeletal development, as well as general growth and development of the fetus.
Because a newborn’s vitamin D level depends on the mother’s vitamin D status, deficiency during pregnancy can lead to rickets (bone softening and weakening) in the child. A recent study confirmed that a mother-to-be’s vitamin D level was related to her child’s bone health.
Children whose mothers had insufficient vitamin D levels during pregnancy were more ly to have reduced bone mass at age nine.
Low vitamin D levels during pregnancy have been associated with an increased risk of numerous complications, including gestational diabetes (high blood sugar during pregnancy), preeclampsia (pregnancy-induced high blood pressure) and bacterial vaginosis (an infection caused by an overgrowth of bacteria in the vagina ). One study found that mothers-to-be with vitamin D deficiency were almost four times more ly to require a Cesarean section.