Vitamin D in Breast Milk

by Christina on July 14, 2016

I just came across this great post on KellyMom (love that site!) about Vitamin D in breast milk.

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She shares this article from Pediatrics and an interesting interview with the lead author:

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In the study they randomized lactating women to a daily Vitamin D supplement of 400 IU/day, 2400 IU/day, or 6400 IU/day. They measured maternal and infant Vitamin D levels at baseline, 4 months and 7 months. They found that supplementing lactating mothers with 6400 IU/day of Vitamin D is safe and provides sufficient Vitamin D in breastmilk (similar to infant supplementation of 400 IU/day).

Here are some excerpts from the KellyMom interview the lead study author Dr. Bruce Hollis, PhD:

How much vitamin D does breastmilk usually contain? Why?

Human breastmilk is a very poor source of vitamin D, usually containing less than 50 IU per quart. This is why the AAP recommends all breastfed infants receive 400 IU per day vitamin D by supplement drops. This IS NOT A DEFECT IN BREAST MILK but a defect in the recommended amount of vitamin D the lactating mom should be taking. If a mom takes 6400 IU per day, she will supply her nursing infant with plenty of vitamin D thru her milk and will not need to give her infant drops.

If a breastfeeding mother knows that her vitamin D blood level is “normal”  does that mean her milk will contain enough vitamin D?

NO! The 25(OH)D in your blood is not a good reflection of the amount of vitamin D that is available to pass into breastmilk. They are two different compounds. Since Vitamin D (rather than the active metabolite 25(OH)D) is the form that passes into a mother’s milk, the only sure way to know it is there is to take it every day. 

The Institute of Medicine has set the “upper limit” of recommended intake at 4000 IU. Is it safe for an adult to take 6400 IU?

The IOM setting a limit of 4,000 IU per day was subjective and not based on any trials. The Endocrine Society guidelines state that 10,000 IU per day is safe. In my own experience with our trial and several other trials in which I have been involved (involving tens of thousands of patients), not a SINGLE adverse event has been observed due to vitamin D intake. I personally take 6,000 IU per day and have for years, and my daughter just had a child and is taking 10,000 IU per day while lactating (going on a year now). Totally safe.

In this pregnancy I’ve been taking about 2000 IU/day of Vitamin D and plan to start upping this soon. Vitamin D supplementation is something I thought about quite a bit after my first son was born –– I wanted to make sure I was getting enough Vitamin D for him. I had increased my daily supplement to 5000 IU/day hoping a sufficient amount would pass on through my milk. Once he started solids we started putting Vitamin D drops in his morning oatmeal (in addition to DHA and probiotics).

Glad to see the research is showing this is effective!

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Nesting and re-energizing

by Christina on July 8, 2016

Working in primary care, being a mom to a toddler, and being pregnant has certainly taken its toll. Baby boy #2 could be coming any day and I’m now officially on maternity leave.

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While I’m really excited to meet our littlest love, I’m also hoping for a bit more time before baby comes…. I’ve been cherishing this time nesting, spending special time with my almost-2 year old, and working my way through my neglected reading and podcast list.

Below is my reading/podcast list that’s been giving me renewed energy and excitement:

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I’m also finally catching up on blog reading and came across this beautiful letter that I have to share again! It’s from the Littles, Love and Sunshine blog:

Dear fellow thirtysomething mum,

I see you in the supermarket, I see you at the playground. I see you at the school drop-off, I see you on the train and in the kid-friendly restaurants. Sometimes you see me too, and we exchange a little smile, an eye-roll, an “I get it” moment. More often you don’t see me – you are chasing your toddler down the aisles, watching your pre-schooler like a hawk as she climbs higher than you’d like, admonishing your kid for pinching her brother, reaching for a wet wipe, mopping up a spilled drink.

A few days ago I was at our public swimming pool, and if ever there was a stark metaphor for life as a mum in her 30s, the public swimming pool has to be it. There we all are – the stereotypes we swore we never would be – wading knee-deep in the kiddies’ pool, eyes locked on our littles – and genuinely delighted by their antics. Although we may be there in pairs or groups, our conversations are piecemeal, we cannot relax. Our focus is entirely on our children. We are tired. We are distracted. Our tankini-clad bodies are battle-scarred and utterly not what they used to be.

Up on the hill are the shiny twentysomethings. They are flipping through magazines, chatting to their friends, Facebooking and selfie-snapping on their iPhones. They are rested. They are toned. They are magnificently oblivious to what is coming their way in the future. They don’t even see us. Or if they do, they swear they will never be us.

It’s okay. We were there once, and we know better than to be offended.

You see, the truth is, we thirtysomethings have let ourselves go. No. We have let our SELVES go. We have small children and for the next little while, our SELVES will not come first. We will be sleeping (or not) according to the timetables of our toddlers and/or newborns and/or a combination of the above. Our hair will not be washed as often as we’d like. Sit-ups? What sit-ups? We will be wiping noses and bottoms and messes from the walls. We will be cooking what feels like continuously from breakfast to supper time and not leaving the table until at least a forkful of peas have been eaten. We will spend hours a week kneeling by the side of the bath and then reading “just one more” bedtime story until we pass out on the edge of the toddler bed. We will be fluent in the language of Paw PatrolSofia the FirstPeppa Peg and Doc McStuffins, and will use said characters shamelessly as threats, bribes, or as digital babysitters so we can dash upstairs to grab a shower. We will find ourselves negotiating with terrorists even though we swore we never would. We will answer to “Uppy” and “More” and “I don’t want to”, and we will say “What’s the magic word?” more times a day than we ever imagined possible. This is thirtysomething. It’s not easy – and that’s the truth.

But there is another truth. Up there on the hill, nestled subtly amongst the twentysomethings, are the fortysomethings. They too are rested. They too are toned. They are alone, quietly reading a book. They see us, and they are sympathetic but also a bit smug. They’ve been there and done it and they know it doesn’t last forever. Girls, fortysomething is the holy grail. Fortysomething is coming.

The decade we get our SELVES back.

Not that I want to wish away the time. Although thirtysomething so far is a bit of a blur, it’s also a kind of magic. Never again will I feel a squidgy cheek rest on my chest in the middle of the night. Little arms reaching up to me after a fall. The delicious baby smell and the little pairs of skinny jeans and sparkly trainers. The scooter rides and monkey bars and the bed time stories with a small person in the crook of each arm. Hearing “I want Mummy,” and “Please can you help me?” and “I want to huggle you.”

Yes, fortysomething is coming, and it’s going to be bliss. But don’t let it come too fast. If I’m to lose my self for a decade, motherhood sure is a delicious thing to lose it to.

Love, Catherine

 

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8 yoga lessons from my baby

by Christina on January 9, 2015

A new job and new baby means I am not going to be able to have the physical yoga practice I used to. I’ve really been treasuring my time with Jackson, and have begun to realize how much yoga he is actually teaching me in our time together.

So when I can’t make it to the yoga studio, I can at least try to appreciate his lessons to me:

1) Be present. Jackson lives fully in the present moment. He doesn’t dwell on the past and definitely doesn’t worry about the future.

2) Feel emotions fully. Jackson does not hold back on his feelings. He freely giggles with joy, kicks his legs with excitement when happy, and has a good cry when something is bothering him.

3) Smile with your entire body. Jackson’s smile fills his entire body. It fills his mouth, his eyes, his fingers and his toes.

4) Eat when hungry. Jackson’s body signals when he is hungry and he eats. Just the right amount – not too much, not too little.

5) Don’t stay angry. Jackson gets upset about only reasonable things, fully expresses his feelings, and then lets them go. He would never stay angry, he would never hold a grudge.

6) Wake up with the sun. Jackson loves the mornings and wakes up with the sun. There is so much to see and do and learn.

7) Be less selfish. It’s not about me anymore. Jackson trumps pretty much everything and I wouldn’t want it any other way.

8) It’s not about your physical body. Growing, carrying, and birthing Jackson was a bit traumatic to my body (to say the least). Looking at him makes that sacrifice seem trivial and reminds me to let go of my attachment to my pre-baby body.

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