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Increased Breastfeeding Rates Blamed for Rickets

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Monday, January 30, 2006

The Boston Herald ran an article over the weekend that talks about the resurgence in rickets and blames that resurgence partly on the increased rates of breastfeeding in the last few years. The article claims that mother's milk doesn't contain adequate amounts of Vitamin D and that many breastfeeding mothers refuse to supplement with Vitamin D drops, thus leaving their babies vulnerable to rickets.

From the article:

The boon in breastfeeding -- mother’s milk doesn't have sufficient vitamin D -- is partly to blame. Investigators at Boston Medical Center did a one-year study that found 81 percent of mothers giving birth -- predominantly black and Hispanic women -- and 76 percent of their infants were vitamin D deficient at the time of birth, Holick said. The study has been submitted for publication in a pediatrics journal.

While an increasing number of mothers breastfeed, breast milk doesn’t have an adequate amount of vitamin D, which enables the body to absorb bone- fortifying calcium, doctors said. Some pediatricians don’t tell mothers they need to give their babies vitamin D for fear that they won’t breastfeed -- which has many benefits.

I also found a statement from the La Leche League on the issue:

"Research suggests that people of color, especially religious or cultural groups who wear enveloping clothing should expose their babies' uncovered cheeks to sunlight for just 20 minutes a day to get the needed vitamin D. In cases where this is not possible or the mother is not getting adequate vitamin D, doctors may prescribe a vitamin D supplement for the baby. According to La Leche League International, the world's recognized authority on breastfeeding, rickets has rarely been found in fully breastfed infants. This is true even in northern climates where there is less exposure to sunlight, which activates the formation of vitamin D. Research has shown that human milk contains adequate vitamin D for at least the first 6 months of life."

Couldn't find any reference to their research though...I've heard that cited in a few places, but haven't read the studies.

What's interesting is that the Boston Herald article also mentions the obvious fact that sunlight is one of the primary sources of Vitamin D and that children are spending less time outside. It would seem to me that it's a little more likely that the lack of sunlight exposure may be playing a larger role here than breastfeeding.

Although Nora was exclusively breastfed for 6 months and drank breastmilk until she was about 13 months, we never supplemented with Vitamin D drops. When I spoke with my pediatrician, he said that as long as she had about 10-30 minutes of exposure to sunlight each day, she'd get all the Vitamin D she needed.

It makes me wonder if part of the issue here is not so much the lack of vitamins, but a city verses a country thing. Not sure how much time babies and children in cities like Boston and NYC, but out here in the midwest, there doesn't seem to be much trouble getting plenty of sun exposure for our kids. If anything, there's a movement to keep them lathered up with high SPF lotion and proper clothing to keep them from getting too much sun.

Nevertheless, the American Academy of Pediatrics changed their recommendations two years ago to suggest that infants receive a minimum of 200 international units of vitamin D per day. I looked up a few studies and most tended to focus on an increased risk of rickets in breastfed African-American babies, leading me to wonder if this is more of a genetic issue than a breastfeeding issue.

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  1. Anonymous Anonymous | 2:24 AM |  

    I have been told that the drive to keep children out of the sun is causing rickets - we're covering them up too well :( I've never been told that breastfeeding is a problem though.

  2. Blogger Carrie Willard | 5:07 AM |  

    Stuff like this makes my blood BOIL! If your kid has a normal life and doesn't live in front of the TV, they will get plenty of sunlight. ARGH!

    This is a genetic issue. I wonder what the stats are as far as black mothers joining the Muslim faith? If a substantial number of dark skinned moms are donning the niqab then this could skew the results.

    Blame breastmilk for everything :(

  3. Blogger Jennifer Laycock | 5:57 AM |  

    Natural mom, that's an interesting theory! It makes sense too! Culturally, dark skinned women are more likely to be Muslim and no one could wear the niqab everytime they went out in public without getting a pretty severe Vitamin D deficiancy.

    I went and did some hunting before making this post, but can't find any data or studies to back this up. I did find an article from the BBC that suggested muslim garb may be partly to blame for an increase in rickets, but I also found a letter to the editor that did a pretty good job of explaining why it shouldn't have an impact. (Children under 2 aren't required to cover up, sunlight exposure in own home, vitamin D fortified foods, etc...)

    I dunno...I'm going to go with more video games, less outside games.

    As for the rest of the story, it seems to me like this is an issue of coincidental instead of causal.

    While I have no problem believing that breastmilk is lacking in Vitamin D (after all, they have to ADD it to cow's milk), I believe that's by design.

    Why would breast milk need to have vitamin D if kids can get it just fine from sunlight. We weren't designed to stay indoors all day, so sunlight wouldn't have been an issue for the majority of the world.

    Rickets tends to happen in geographical locations that have very limited sunlight and according to the new news reports, in urban areas where kids don't spend a lot of time playing outside.

    Blaming rickets on breast milk is sort of like blaming sunburn on the trees.

  4. Blogger K | 12:25 PM |  

    Here is what I don't understand --

    why the resistance to vit D drops?

    Nobody is saying "don't breastfeed." Rather the advice is to give vit D supplements.

    Perhaps better advice would be to "get some sunshine." But if that is not possible, vit D drops are a good idea.

  5. Anonymous Anonymous | 12:35 PM |  

    This is interesting. I was one of those BF moms that didn't know any better so when our ped said I had to give Julian Vit D I listened. I remember thinking "BM is supposed to have everything he needs so why do I need this?" Then I asked an LC and she explained it to me and since we aren't high risk, my child does see the light of day and we don't live in a city w/all high rises blocking the sun then he should be fine. I also asked all the other BF moms I knew and none of them gave it so I was thinking WTF am I doing?

    I was so relieved b/c the Vit D smelled terrible, Julian hated it, it sucked giving it to him and we only did it for about 3 days!

    I'm sick of BM getting such a bad rap. "Breast is best" they keep saying and trying to promote but hardly any support for public BF and BM is always blamed as the source of any problem. Any time the slightest issue comes up a dr is so quick to push formula. They need to get their crap together and stand behind what they are saying instead of sabatoging their own message. "Well it's best but it can cause ricketts, fussiness, iron deficiency, etc..." How do they explain all the trillions of people that were healthy when BM was the only option. Why would our bodies produce food for babies if it wasn't perfect. Do they give baby cows vitamin D supplements and tell the mother cow that something must be wrong with her milk?? Yeah this gets my blood boiling too :)

  6. Blogger Jennifer Laycock | 12:48 PM |  

    You know Kelly, I wonder that myself. I didn't give Nora vitamin D drops, even though I went and got the prescription filled.

    I'm not opposed to it, it was just one of those things that didn't seem valuable enough to "remember" each day.

    Sort of like the Vitamin K shots in the hospital...I just don't see the point of them...not so much that I'd fight it in the hospital, but I certainly wouldn't worry about my next child not getting the shot at a home birth.

    Another sign that us breastfeeding moms are just lazy? ;)

  7. Anonymous Anonymous | 1:14 PM |  

    We don't get given or prescribed Vit D, although we have Vit K as drops to be given three times (they left it at home for me to give when I had a home birth ;) )

    I have been told by a medical friend that rickets *is* becoming an issue for adults converts to Islam in this country, and it's put down to the fact that our sun is a lot less powerful and we don't have houses set up with secluded areas for women to sit outside without their hijab. I've also seen children a lot less than 2 fully covered so I would have thought that could easily be an issue.

    Still struggling with how breastfeeding could be all that much of a problem - possibly the advice to keep children out of the sun, yes, breastfeeding, no.

    A more regular accusation here is that children won't get enough iron if you breastfeed them.

  8. Blogger K | 1:37 PM |  

    Ha! Funny about BF moms being lazy! So not the case. Indeed, EPers are likely the most non-lazy folks I could ever imagine!

    I did not realize the drops were unpleasant. I understand the resistance if that is the case. I was just curious if there is a problem with perhaps getting too much vit D if one is exposed to sunlight and receives the drops.

    One more thing -- how can we blame BF for anything when the stats still show that by six months, most babies are not bf?!

  9. Blogger Jennifer Laycock | 1:44 PM |  

    The original article said that the rickets were more prevalant in children that were breastfed and went on to say that the increase in rickets was likely tied to the increase in breastfeeding.

    Of course with no access to the research data, it's hard to tell if their studies were legit or flawed.

    Sort of like the study that showed home birth to be SOOO very dangerous, but when you dig a bit deeper, you find out that it's because it includes every single instance of home birth (including miscarriages and emergency births) rather than PLANNED home births.


  10. Anonymous Anonymous | 1:26 PM |  

    this is such an old post, but i just wanted to say that the reason this is being found in african-american babies is because darker skin pigment blocks uv rays and keeps your skin from making enough vitamin d. there has been a substantial rise in the number of black infants that have been breastfed in the past 25 years, and i'm not sure if there has been a similar decrease in the time they spend outside. that's why the studies blame breastfeeding, although i don't think this is justification for not breastfeeding. but this is why many lighter skinned babies may not need the drops.

  11. Anonymous Sankofa | 4:18 PM |  

    The notion that breast feeding is a cause of rickets is not only asinine but one of numerous examples of junk science meted out by people who are trained to deal with "symptoms" as opposed to disease. This (1) an attack on breast feeding -which is a natural means of mother/child bonding and preparation for building the immune system.. (2) This is an attack on an alternative way of living, because more people are exploring a lifestyle free of chemicals and pharmaceutical poisons administered by medical professionals with stakes in the newest drug. (3) Another form of attack on African people, because the myriad of lies around AIDS being natural to Africa, African Americans, Haitians etc have been proven by numerous sources as a crock pot full of colonial dreams.

    How can African people lack being in sunshine thus susceptible to rickets? Africa? Sun shine? The two go together don’t they? Now alternative medicine teaches that the body will take and utilize all it needs then pisses out the rest. Mother’s milk is native and natural to babies (a species whose brain grows first before the body). We are not genetically disposed to drinking the milk of a different species where that species’ body naturally grow enormous first and less so in brain capacity. Modern doctors don’t know anything about bone disease other than some regurgitated crap spouted over and over. Ultimately the lack of vitamin D is not really a lack, but the body’s inability to process Calcium due to kidney and liver malfunction. Any high school biology student will affirm that if the kidney and liver malfunctions, then the body is out of whack from a lifestyle of bad diet, environmental poisons and chemical poisons-including allopathic medicine. Conversely if you have a lifestyle of bad diet, environmental poisons and chemical poisons-including allopathic medicine, you will have kidneys and livers…out of whack.

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