Instructions for vitamin D supplementation for post-birth mothers

Article by Dr. To Thi Thanh Huong – Obstetrics and Gynecology Center – Share99 Times City International Health Hub

The content of vitamin D in breast milk is very low, even if the mother is being supplemented with vitamin D- containing vitamin D. In particular, in cases where people are black or already have vitamin D deficiency. Vitamin D supplementation is essential to support the normal development of young bones, prevent rickets and bone deformities or diseases caused by weak bone structure associated with calcium deficiency.

Vitamin D is a fat-soluble vitamin that exists in 2 forms, vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol) play an essential role in bone creation, calciummetabolism , phosphorus in the body.

The content of vitamin D in breast milk is very low, even if the mother is being supplemented with vitamin D- containing vitamin D. Especially in cases where people are black or already have vitamin D deficiency . Vitamin D supplementation is essential to support the normal development of young bones, prevent rickets and bone deformities or diseases caused by weak bone structure associated with calcium deficiency.

Rickets in babies who are breastfeeding may occur without vitamin D supplements (food or vitamin D supplements) or sufficient exposure to the sun. Therefore, all babies should be given vitamin D supplements for the prevention of rickets, especially in cases of vitamin D deficiency. However, some evidence suggests that vitamin D supplementation during breastfeeding does not improve vitamin D levels in breast milk. Thus, it is possible to choose a variety of approaches: Vitamin D supplements for mothers (continuous doses or single high doses), or vitamin D supplements for babies (recommended dose 400UI /day).

The current recommendations and evidence of vitamin D supplementation for post-birth maternity are as follows:

• Babies under 4 months of age and pregnant women who are breastfeeding are subjects recommended by NICE to take vitamin D supplements.
• NICE and SACN recommend that pregnant and lactation women receive regular vitamin D supplements of 10 micrograms (or 400UI/day) per day, and health workers should advise all pregnant and breastfeeding women of the importance of vitamin D supplements for their health and development.
• The Food and Nutrition Department of the National Academy recommends additional doses of vitamin D for pregnant and lactized women of approximately 600 UI/day. However, the Nutrition Department of the American Academy of Pediatrics suggests that the required dose of vitamin D may be higher than this recommendation.
• ACOG: vitaminD intake dose 1000 – 2000 UI/day for pregnant women in cases of vitamin D deficiency is safe. High-dose vitamin D use data is missing for vitamin D deficiency subjects during pregnancy.
• Some recommendations from studies of Vitamin D supplementation dose 4000 – 6400 UI / day (10 times higher than the recommended content) to increase the concentration of vitamin D in breast milk to the level that meets the vitamin D needs of babies, however, these recommendations are very little recommended for use.

Note: Avoiding high-dose vitamin D supplementation, a report found that doses of ergocalciferol (D2) 2500 UI (doses 150 times higher than recommended supplements) resulted in toxicity levels in breast milk.

From the current evidence and recommendations, the post-birth vitamin D supplement should consider the following considerations:

• In all cases, it is possible to take regular vitamin D supplements with a regular dose of 400UI/day (the basic dose in today's vitamin tablets).
• Vitamin D supplements should specifically depend on each group of subjects: race, dark skin color, less sunlight exposure, vitamin D deficiency.
• Consider supplementing vitamin D for mothers with the aim of improving the amount of vitamin D in breast milk, instead it is possible to directly supplement vitamin D for babies.
• Vitamin D supplement diet: Some healthy foods are high in vitamin D: salmon, herring, sardines, fish liver oil, oysters, shrimp, egg yolk, mushrooms, cow's milk, orange juice, cereals … can be supplemented after birth for mothers who are breastfeeding

At Share99 International Health Hub, there is a full maternity service as a solution to help pregnant mothers feel secure because there is a team of doctors throughout the pregnancy. When choosing a full-service maternity, a pregnant woman can:

• The process of pregnancy is monitored by a team of specialists
• Regular examination, early detection of abnormalities
• Package maternity for the convenience of childbirth
• Infants receive comprehensive care

To register for examination and treatment at Share99 International Health Hub, you can contact Share99 Health System nationwide, or register for an online examination HERE

References:

1. Unicef, 2017, Statement on vitamin d supplementation for breastfed babies.
2. NICE, 2017, Vitamin D: supplement use in specific population groups
3. ACOG, 2019, Vitamin D: Screening and Supplementation During Pregnancy

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