The Vitamins in Breast Milk

What They Do and What Is Lacking

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Vitamins are essential for your baby's growth and development. If you're a healthy mom who eats a well-balanced diet and takes a prenatal vitamin, your breast milk contains most, if not all the vitamins that your healthy full-term baby needs. Experts sill recommend a few supplements. But, for the most part, your breast milk has enough custom-made nutrition full of all the nutrients, including vitamins, to support your child as he grows.

Here are the main vitamins found in breast milk.

Vitamin A

Vitamin A is necessary for healthy vision. Your breast milk contains enough vitamin A for your child. Colostrum, the breast milk that your body produces during the first few days of breastfeeding, has twice as much Vitamin A as transitional or mature breast milk. These higher levels of vitamin A, especially beta-carotene, is what gives colostrum it's yellow-orange color. Formula-fed infants may need extra vitamin A, but breastfed children do not.

Vitamin D

Vitamin D helps to build strong bones and teeth. There is vitamin D in breast milk, but the levels vary from woman to woman depending on how much Vitamin D she gets. You can get some vitamin D from your diet, but since you get most of your Vitamin D from the sun, your skin tone and where you live play a significant role in the amount of sun exposure and Vitamin D that you'll get. Because of these factors along with the protective measures that women often take against sun exposure, many mothers do not have enough Vitamin D in their breast milk.

When babies do not get enough Vitamin D, they can develop a disease called rickets. Rickets causes soft bones that can break, bow legs, and other bone problems. Due to the risk of rickets in exclusively breastfed babies whose mothers are deficient in vitamin D, doctors recommend that all breastfed infants receive a vitamin D supplement of 400 IU a day starting right after birth.

Vitamin E

Vitamin E protects the cell membranes in the eyes and the lungs. There is more than enough vitamin E in breast milk to fulfill the recommended daily requirements.

Vitamin K

Vitamin K is involved in the production of blood clotting factors that help to stop bleeding. It's given to all infants when they're born. After a dose of vitamin K is given at birth, healthy breastfed babies and their mothers do not need any additional vitamin K supplementation. However, if there's concern about your vitamin K levels, your doctor will prescribe vitamin K supplements to increase the levels of vitamin K in your breast milk.

Vitamin C

Vitamin C (ascorbic acid) is a strong antioxidant. It helps to heal the body, support the immune system, and aid in the body's absorption of iron. Vitamin C also prevents a rare disease called scurvy.

Breast milk contains plenty of vitamin C. You do not need to take extra vitamin C supplements, and you do not have to supplement your breastfed baby with vitamin C. Even if you don't take any additional vitamin C, your breast milk will still have two times more than the recommended amount for formula.

However, smoking decreases the amount of Vitamin C in breast milk, so if you smoke will have lower levels, and you may need to add more citrus fruits or a daily vitamin C supplement to your diet.

Vitamin B6

Vitamin B6 is required for healthy brain development. Your diet influences the amount of vitamin B6 in your breast milk. But, if you have healthy eating habits, it's not necessary to take B6 supplements. A typical daily supplement dose of B6 will increase the amount of B6 found in the breast milk and is considered safe. However, very large doses of B6 have been found to decrease prolactin levels and, therefore, the amount of breast milk that you make.

Folate

Folate contributes to the health and development of children. The amount of folate in breast milk is directly related to your diet.

The supplement form of folate is folic acid. If you're not already taking a prenatal vitamin with folic acid, you can take a folic acid supplement of 0.4 mg (400 mcg) a day to make sure you're getting enough of this important vitamin.

Vitamin B12

Vitamin B12 is needed for cell growth and the early growth and development of the nervous system. It is found in animal products such as milk and eggs. If you follow a strict vegetarian or vegan diet, or you've had gastric bypass surgery, your breast milk will most likely be deficient in vitamin B12. You can correct the deficiency and increase the levels of B12 in your breast milk by taking a supplement.

Thiamin (B1), Riboflavin (B2), Niacin (B3), and Pantothenic Acid (B5)

All B vitamins help to convert food into energy that the body needs to grow, develop, and function. They are also necessary for the skin, hair, eyes, and the nervous system including the brain. Thiamin, Riboflavin, Niacin, and Pantothenic Acid can be found in breast milk at levels that depend on your diet. In countries such as the United States, it is rare for a healthy woman to have breast milk that is lacking in these vitamins. And, when a healthy mother is breastfeeding a healthy full-term infant, the levels of these vitamins in the breast milk fulfills the daily recommended levels.

However, if you're poorly nourished, or you follow a diet that does not include a variety of healthy foods, there is more of a chance that the levels of these B vitamins in your breast milk will be lower. In situations such as these, you can use vitamin supplements to raise the levels of these vitamins in your breast milk.

The Vitamins (and Minerals) Breast Milk May Lack

If you have a healthy diet, your breast milk should contain almost all the vitamins that your baby needs. However, even if you follow a healthy breastfeeding diet, you may find that your breast milk is low in certain vitamins. If you are exclusively breastfeeding, there are a few vitamins and mineral supplements that your child may need. For example, since many mothers do not get enough Vitamin D, a vitamin D supplement is usually started right away. Iron supplements are typically added by four to six months of age, and depending on your water supply, the doctor may recommend a fluoride supplement at six months. Preemies, baby's born with health concerns, and babies of moms who follow a Vegan diet or have had weight loss surgery may need additional supplements, as well. You should be sure to follow the recommended well-visit schedule that your child's doctor gives you. The doctor will monitor your baby's health and prescribe the vitamins that your child needs.

How to Tell If You Need Vitamin Supplements

Your doctor will use your health history, prenatal examinations, and routine blood work results to decide which vitamins, if any, you need to take while you're breastfeeding. So, besides choosing healthy foods to eat, you can continue to take your prenatal vitamin and any other supplements that your doctor recommends. By following your doctor's advice and recommendations for follow-up care, you can feel confident that you're doing all you can to ensure that your breast milk contains all the necessary vitamins, and it's is as healthy as it can be for your child.

Sources:

Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatric Clinics of North America. 2013 Feb;60(1):49.

Eidelman, A. I., Schanler, R. J., Johnston, M., Landers, S., Noble, L., Szucs, K., & Viehmann, L. Policy Statement. Breastfeeding and the Use of Human Milk. Section on Breastfeeding. 2012. Pediatrics, 129(3), e827-e841.

Lawrence, Ruth A., MD, Lawrence, Robert M., MD.  Breastfeeding A Guide For The Medical Profession Eighth Edition. Elsevier Health Sciences. 2015.

Riordan, J., and Wambach, K. Breastfeeding and Human Lactation Fourth Edition. Jones and Bartlett Learning. 2014.

Valentine CJ, Wagner CL. Nutritional management of the breastfeeding dyad. Pediatric Clinics. 2013 Feb 1;60(1):261-74.

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