Date
17 December 2017
Breastfeeding is beneficial to babies, but moms should bear in mind the possible inadequate supply of Vitamin D. A mother needs to amplify her own intake of Vitamin D so that she can provide enough such nutrient in her breast milk. Photo: HKEJ
Breastfeeding is beneficial to babies, but moms should bear in mind the possible inadequate supply of Vitamin D. A mother needs to amplify her own intake of Vitamin D so that she can provide enough such nutrient in her breast milk. Photo: HKEJ

Vitamin D deficiency in breastfed babies

I was told by my medical peers that calcium deficiency is a frequent topic brought up by mainland parents in discussions with paediatricians. 

If you wonder how the issue became a key talking point, you can bet the answer lies with the barrage of messages emanating from the Internet. While keeping oneself informed is always good, in this case, however, I’m afraid parents could be receiving incomplete or even biased information that could prompt needless redundant worries.

I would like to take the opportunity to explain further on nutritional rickets — a common form of growing bone disease with an etiology ranging from isolated vitamin D deficiency to isolated calcium deficiency — which is a rare instance that has been recently reported in the latest issue of the Hong Kong Journal of Paediatrics.

A four-year-old local Hong Kong boy was diagnosed with nutritional rickets which was caused by very prolonged breastfeeding. He suffered from shorter height than his same-age peers and the presence of genu valgum (knock-knees).

Rickets is primarily caused by a lack of vitamin D or calcium, which would then lead to bone deformities in children due to softer and weakened bones. Common signs and symptoms for the condition include shorter height and bowed legs.

Rickets is more commonly noted in developing countries where children might also be facing the risk of malnutrition. The condition is perceived as uncommon in Hong Kong, though there are no official statistical records to support such claim.

In the past decade, the trend of infant feeding has been switched to breastfeeding from formula feeding. Generally speaking, while content of calcium and vitamin D is certainly high enough in formula milk, breast milk is deemed to be a very poor source of vitamin D. That explains why the boy in the case would suffer from the illness.

As a matter of fact, back in 2008, the American Academy of Pediatrics had recommended parents of infants who are either breastfed or consuming less than one liter of infant formula per day to give the infants an oral Vitamin D supplement to meet the current recommendation, which is 400 international units (IU) per day.

However, the recommendation has not been widely promoted in Hong Kong, given that the city is always has sufficient sunlight, which is already a good source of the nutrient. In order to obtain sufficient intake of vitamin D, it is said that a person just needs exposure to sunlight thrice a week, with each session lasting at least 15 minutes.

Yet, logically, mothers who practice breastfeeding would be in need of a higher intake of vitamin D, so as to provide their infants with sufficient amount of it.

Since most mothers in Hong Kong keep working and spend long hours inside offices or other commercial buildings, it is not easy for them to get sunlight exposure. Besides, as the city’s air pollution is getting worse, the effectiveness of sunlight for vitamin D generation in the body is also reduced.

Given this situation, it would be a wiser and safer option if parents consider giving their children Vitamin D supplement to protect the kids from rickets risk.

This article appeared in the Hong Kong Economic Journal on June 16

Translation by John Chui

[Chinese version 中文版]

– Contact us at [email protected]

JC/FC/RC

FHKAM (Paediatrics)

EJI Weekly Newsletter

Please click here to unsubscribe