Vitamin D. Recommendations for pregnant women and breastfeeding mothers. Excellent Care with Compassion

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1 Vitamin D Recommendations for pregnant women and breastfeeding mothers Excellent Care with Compassion

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3 Introduction The Department of Health recommends that pregnant and breastfeeding women should be given information and advice on the benefits of taking a daily supplement of 10 micrograms of vitamin D. What is vitamin D? Vitamins are essential to our health and vitamin D plays an important role in the development of our bones and teeth. How do we get vitamin D? We obtain many vitamins from the food we eat, but vitamin D is unusual because most of the vitamin D we need is made when our skin is exposed to sunlight. Only a small amount is obtained from our diet. Vitamin D is contained in the following foods that should be eaten as part of a healthy diet: Oily fish such as sardines, kippers, salmon, pilchards and trout. Meat and eggs contain a little vitamin D. Some margarines and breakfast cereals are fortified with vitamin D During pregnancy vitamin D is transferred from the mother across the placenta to her baby. This is essential to meet the newborn baby s need for vitamin D in the first few months of life. What happens if we do not get enough vitamin D? Without vitamin D, bones may not develop as strongly as they should. Low levels of vitamin D in children can lead to a condition called rickets; bones are soft, can become deformed and fracture easily. There is developmental delay, particularly with walking, and admission to hospital for treatment may be needed. In adults a lack of vitamin D can cause a painful softening of the bones called osteomalacia. Many people believe these conditions only occurred in the past but 3

4 new cases of adults and children with low levels of vitamin D are still regularly diagnosed. Vitamin D is particularly important in pregnancy as low levels in the mother can mean that the baby is born with low levels of vitamin D. How can I make sure I get enough vitamin D? Spending a short time outside each day helps to build our stores of vitamin D, especially during the summer months. It is only necessary for this to be 15 minutes and only your hands and face need to be exposed to the sunlight. If you have dark skin this is particularly important. It is important to observe safe sun guidance and to avoid burning by using a sunscreen and not being out in the sun between 11am and 3pm. This is especially important if you are fair skinned. Eat foods containing vitamin D. Take a vitamin D supplement. How do I decide whether I need to take vitamin D supplements? Your midwife will discuss this with you. Some women are known to be more vulnerable to vitamin D deficiency than others: If you spend a lot of time indoors or cover up when going outside it may be that you do not have sufficient exposure to sunlight. If you are on a low income it may be difficult for you to eat a healthy diet. If you are under 25. If you come from South Asia, Africa, the Caribbean or the Middle East. If your diet contains little or no oily fish, margarine, eggs or breakfast cereal. If you are overweight, meaning you have a raised BMI of over 30. 4

5 If any of the above applies to you, your midwife will remind you of the importance of obtaining adequate amounts of vitamin D from sunlight and diet. In addition it is advisable to take an appropriate vitamin D supplement. Even if you do not fall into a vulnerable group you may still benefit from taking a vitamin D supplement when you are pregnant. Where can I obtain vitamin D supplements? If you are registered with the Healthy Start scheme you can obtain free Healthy Start vitamins containing the recommended dose of vitamin D from the clinics listed at the end of this leaflet. Other women may be able to purchase Healthy Start vitamins from the same clinics and this is probably the most inexpensive option. Alternatively ask your local pharmacist, your GP or your midwife to recommend a suitable supplement. Do I need to take any other vitamins? Healthy Start vitamins contain folic acid, vitamin C and vitamin D. Once you are taking Healthy Start vitamins you can stop taking any other folic acid tablets you may have been prescribed. Is there anything else I can do? It is important for everyone to know about healthy eating. Vitamin D is just one small, but important, part of our diet. You should try to eat a variety of different foods and take regular meals. Eating 5 portions of fruit and vegetables, avoiding foods high in fat, sugar and salt and drinking plenty of water each day is good for you. What happens after I have had my baby? All women are encouraged to breastfeed their babies to give them the best possible start in life. If you have been advised to take vitamin D supplements during pregnancy and you decide to breastfeed your baby you should 5

6 continue with your supplements until your baby is 6 months old. If you are not in a vulnerable group and are breastfeeding it may still be advisable to take a vitamin D supplement until your baby is 6 months old in order to make sure that your baby has adequate levels of vitamin D. Mothers whose babies are given artificial formula do not need to take supplements. Healthy Start vitamin drops, containing vitamin D, are given to all babies from 6 months up to 4 years. Healthy Start vitamins can be obtained from the following clinics: Health Centre Address Telephone Ashton Peddars Lane Avenham Avenham Lane Fulwood 4 Lytham Rd Ingol Village Green Lane Ribbleton Langley Rd Saul St Sizehouse St St Mary s Cop Lane Leyland Yewlands Drive Bamber Bridge School Lane Chorley Collison Avenue Coppull 2 Springfield Rd Adlington Railway Rd Eccleston Doctors Lane

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8 Sources of further information Lancashire Teaching Hospitals NHS Foundation Trust is not responsible for the content of external internet sites. Please ask if you would like help in understanding this information. This information can be made available in large print and in other languages. Division: Maternity Directorate: Surgery Production date: Sept 2016 Review date: Sept 2019 LTHTR/Tr/2013september/44 Excellent Care with Compassion