Vitamin D And Infant Formula A Risky Combination
Data from a recent study presented at a meeting of the American Federation of Medical Research revealed for the first time a possible link between vitamin D supplements and formula feeding and an increased risk for urinary tract infection (UTI) in babies.
Dr. Robert Gensure and his colleagues at the Ochsner Health System in New Orleans were researching the role of vitamin D in preventing rickets in breastfed babies. After the first baby enrolled in the study developed a UTI, Ochsner’s safety monitoring board asked the researchers to investigate a possible link to vitamin D. A retrospective analysis revealed a never reported result—a significant association between formula-fed infants receiving vitamin D supplements and UTIs.
A group of 315 babies (189 formula-fed and 125 breastfed) participated in the retrospective chart review. Findings showed that the formula-fed infants were twice as likely as the other infants (breastfed and mixed-fed) to develop UTIs. In addition, the researchers found that breastfeeding was not protective against UTIs.
There are no plans to do a prospective national study given that UTIs are rare in babies. However, there are case reports of older children in which excessive levels of vitamin D have been associated with UTIs, highlighting concerns over vitamin D supplementation and the perception on the part of some parents that more is better.
The American Academy of Pediatrics (AAP) recently increased its recommendation for vitamin D from 200IU to 400IU a day beginning shortly after birth. This recommendation does NOT apply to babies who consume a quart or more of formula each day since commercial formulas sold in the United States already contain 400IU of vitamin D.
The take home message for parents
- Know the recommended amount of vitamin D (400IU a day for all exclusively breastfed babies and babies consuming less than one quart of vitamin D fortified infant formula a day).
- Give ONLY the recommended amount of vitamin D.
- Know that more than the recommended amount of vitamin D is not necessarily better and may actually increase babies’ risk for infection.
While Vitamin D supplementation has been shown to help prevent a number of neurocognitive diseases and is extraordinarily important, it CAN be toxic. Ordinarily I’d say it’s important to get tested for Vitamin D deficiency, but it seems as though it might be a little harder to accomplish this in young children.
Thank you for this important reminder. Given that we live in a society where many people believe that more is always better, it’s important for parents to know that toxicity is a concern when any of the fat soluble vitamins (A, D, E, K) are taken as supplements.
Unfortunately, how much vitamin D is needed to prevent vitamin D deficiency remains unclear. So many factors influence vitamin D levels, the amount of supplement needed to achieve adequate levels likely varies widely among individuals.
While many physicians are beginning to routinely test adults for vitamin D deficiency, routine testing of children has yet to be implemented. There have been several studies in which women were given as much as 6000 IU of vitamin D daily and successfully achieved adequate breastmilk levels of vitamin D, thereby eliminating the need to supplement their breastfed infants. Larger studies are currently underway to see if breastfeeding can be a mechanism for achieving adequate vitamin D levels in infants.
Given all the research currently underway in this area, baby gooroo looks forward to sharing a lot more information on vitamin D in the future.