Advice for Parents
If you are a white mother anywhere in the UK breastfeeding in Winter or Spring:
The risk: if you follow all of the current guidelines, our analysis is that your baby is at significant risk of vitamin D deficiency or serious vitamin D deficiency during the first six months of life. The main health consequences to be concerned about are a risk of impaired bone development, and impaired ability to avoid or manage infections.
Recommended actions if you want to avoid vitamin D deficiency in your child during the first six months of life:
- Take all of the supplements recommended in the current NHS guidelines, for you as a preganant of breastfeeding mother – if you do not know what these are then ask your health professional or your chemist.
- Speak to your GP and raise your concerns with them. Point them to this website. What you are asking them to do, is to support the decision, that the right thing is to give your baby direct supplementation with vitamin D3, beginning from the first few days of life, until you change to giving your baby the official recommended “healthy start” type drops at six months. You would be requesting that they follow the guidelines of other countries, e.g. USA, Canada, Germany, France, Ireland, Holland, Sweden, Norway, Finland etc
Links for your GP, to the USA and to the Canadian guidelines are here:
GPs in the UK are not able themselves to prescribe pure vitamin D3 preparations for infants without exposing themselves to legal risk! So until this is changed, what you are after, is their advice on whether or not it is OK for you to buy the drops or other melt-in-the-mouth preparations yourself – they are available from many chemists, and you can order them online through Amazon. Check with your GP that you are ordering is correct. You must consult with your GP, as there are rare conditions which might mean that your baby should not receive these supplements, and because all medication you give to a young infant should only be given with the support of your main health professional.
- From the age of six months, follow the official NHS guidlines diligently: Give your child a supplement of 7 micrograms of vitamin D per day until their sixth birthday.
The supplement should be of vitamin D3, not vitamin D2. Vitamin D3 is the natural form of vitamin D produced in our bodies, and it has not been established that vitamin D2 (the plant form of vitamin D) is equivalent to vitamin D3 in all cellular pathways.
- If you are a white mother who is pregnant or breastfeeding in Scotland or Northern Ireland in winter or spring, the risks are much higher. Have your own vitamin D level checked (this is the standard of care in the USA and in Australia and New Zealand), and that if you are found to be deficient or ‘insufficient’. Ask your GP for advice
- If you think the current situation is highly unsatisfactory, or if your GP does not feel able to help, you may want to email the Chief Medical Officer of the region in which you live, detailing your experiences. Email addresses for all of the Chief Medical Officers in the UK are given at the bottom of this section.
If you are a South Asian or African in England or Wales and are pregnant or breastfeeding:
The risk: if you follow all of the current guidelines, your baby is at serious risk of acute vitamin D deficiency during the first six months of life. The health consequences to be concerned about are a serious risk of rickets, seizures, heart problems, and even death.
- Take all of the supplements recommended in the current guidelines. However, our research suggests that this will not be enough.
- Speak to your GP.
- Have your own vitamin D status checked and corrected
- Get your doctor to prescribe pure vitamin D drops for your infant, or get instructions from your GP about what vitamin D supplement to purchase and administer to your baby. Supplementation should begin during the first few days of life until 6 months old. Point out to your GP that the source document for the current guidelines (SACN 2007) includes the provision that:
“The UK RNI for vitamin D for all pregnant and breastfeeding women is 10μg of vitamin D daily, and for breastfed babies is 7-8.5μg daily from the age of six months or earlier if there is increased risk of deficiency by virtue of low maternal status. The UK RNI for vitamin D for all pregnant and breastfeeding women is 10μg of vitamin D daily, and for breastfed babies is 7-8.5μg daily from the age of six months or earlier if there is increased risk of deficiency by virtue of low maternal status”. (Paragraph 109, page 35)
Point out that as a South Asian or African mother you fall into the category of ” low maternal status” . If there is any disagreement about this, ask to have your vitamin D level measured ASAP.
If you have not been exactly following the guidelines on taking absolutely every vitamin D supplement every day yourself, you can tell your GP that your status is questionable, and on the current guidelines they have issued to them, (see here) they should start giving your baby a pure vitamin D3 supplement from 1 month. Hopefully your GP will co-operate, even though the Health Service may have made this difficult for them. In the worst case, if your GP refuses to cooperate, they are exposing themselves or their health service to the risk of a claim for negligence.
- If you have difficulty getting the support we have advised, or if you think that the current position in terms of guidelines for the South Asian and African community is unacceptable, email the Chief Medical Officer of your region and have this issue raised with your MP.
- Follow the current guidelines diligently from age six months to 4 and a half years.
- Information you might like to take to your GP:
American Pediatric Guidelines 2008