vitamin d deficiency

For this week’s parenting topic, we’re taking a look at vitamin D and your baby – while at a pre-natal class recently we’d heard that supplementation was advised right from birth, which triggered some alarms, since many vitamin D supplements aren’t vegan friendly. With that, we turned to the Council of Vegan Parents and the internet (have you tried that thing? It’s awesome!) for answers!

First, an overall disclaimer – not to weasel out of anything that appears below, but you really shouldn’t get your health and nutrition information from Some Guy On The Internet. Everything that looks like science in this article came via guidance from the National Institutes of Health in the USA and Health Canada, and I encourage you to follow those two links for the current state of vitamin D recommendations. As with all of our parenting columns, I reached out to the Council of Vegan Parents, but for this one I used their input as background on what a decent subset of the vegan parenting population was doing.

Secondly, even if you don’t have kids, this article might be pretty important, since most of it has to do with availability and requirements in everyone, but we’re paying more attention to infants, is all.

Why does any of this matter?

It turns out that vitamin D has been linked with a lot more than rickets, which was the primary concern when it was added to cow’s milk in the USA in the 1930′s. Research is suggesting links between vitamin D deficiency and issues including cancer, multiple sclerosis, diabetes, hypertension, depression, and possibly even autism.

What’s more, there’s been growing concern that current “acceptable” levels of vitamin D in the body are actually significantly lower than some new suggested levels that are going around.

This isn’t just a vegan problem, by the way – while there are some non-vegan foods with vitamin D in them (either naturally or through fortification,) the percentage of the North American population that’s deficient (by current or proposed guidelines) is much higher than the percentage of the population that’s vegan.

Is sunlight enough?

Worldwide, sunlight is the primary source of vitamin D: your skin synthesizes it after absorbing ultraviolet B radiation from the sun. With that said, there are a number of factors that need to be considered before we all start praying to the sun god for all our (and our baby’s) needs:

First and foremost would be the conflict between the “absorb sunlight” and “don’t expose your baby to sunlight” recommendations. The American Academy of Pediatrics recommends keeping babies out of direct sunlight for the first six months. I’ve seen many other (non-medical) sources saying that five or ten minutes a day isn’t a problem, and might be enough to synthesize enough vitamin D, but I haven’t done enough research on the topic to do more than repeat the AAP recommendation.

Even with sunlight, depending on where you live it might not be enough through the entire year. The NIH says that, in the USA, you need to live below 34 degrees North latitude (which stretches from Los Angeles, California through Columbia, South Carolina) to be able to use sunlight as a sole source year round. In other regions, a window from November through February (or larger) is a “dead zone” for sufficient sunlight.

Skin pigmentation is also a factor: paler skin absorbs UV radiation faster than darker skin does, which means that darker skinned people (both adults and infants) need to spend more time in the sun for the same dosage – up to 10 to 20 times as much, according to the Health Canada information.

Cloud cover, smog, shade and other factors can also reduce the radiation levels significantly, and the use of sunscreen above SPF 8 will reduce your ability of vitamin D absorption to pretty near zero (OK,it’s a 97.5% drop, which I’ll call “close enough.”)

Generally, advice seems to be that the hours between 10AM and 3PM are the best times to be soaking it in, as it’s when the sunlight is strongest.

Will breastfeeding supply vitamin D?

Vitamin D does exist in breast milk for mothers with adequate levels themselves, but it’s not considered enough to meet the daily recommended levels. On a semi-related note, your baby may have some vitamin D on backup from what it got through the placenta while in the womb, but this usually is only enough for a few months at most.

What supplements are available?

As we mentioned in our article about vegan infant formula, there doesn’t seem to be any formula out there with vitamin D2 instead of D3. Briefly, there are two forms of D: D2 (ergocalciferol) and D3 (cholecalciferol.) D3 is derived from lanolin (wool) and sometimes fish or egg, so it’s not considered vegan. D2 is made from yeast. I remember the “good” one because I like Star Wars (R2-D2) and “I am vegan, ergo I make up silly mnemonic devices.”

As for supplements, there are many liquid drop supplements of vitamin D that would be easier to administer than a pill or a powder, but the majority are based on D3. As Julie from the Council noted, be careful to read the labels, since most D3 is lanolin-derived, which is wool, so the bottle could say vegetarian but not be vegan.

We live in a disclaimer-filled world, but one more probably won’t fill the internet: check with your health professional to determine suitability of any or all of these – other than “you can buy it,” “it’s liquid,” and “it’s D2″ we’ve done no vetting of these products whatsoever but hope they help speed up your search.

• Meredith pointed out this D2 spray.
• Monica mentioned Dalivit, which looks like it has to be ordered from the UK but doesn’t seem too expensive – here’s one source.
• Jodie left a comment about Drisdol Drops [PDF], which it looks like you can get from any pharmacy.
• Wow, I wish there were more items here! Please let us know what you’ve found in the comments and I’ll update the list!

Once your child has teeth, there are some vegan chewables out there that might be appropriate, including Freeda Vitalets and the VegLife Vegan Kids Multiple [affiliate links].

Depending on what country you live in, you might have access to fortified soy milk (or other plant-based beverages,) but it’s important to note that these aren’t viable nutritional substitutes for breast milk or formula.

Remember – it’s testable

This goes for infants and adults – vitamin D levels in the blood can be measured by your health care people, so if you’re concerned about current levels or your intake plan, it’s pretty straightforward to get a status check (subject to costs for some of you, of course.)

As I mentioned earlier, this isn’t just a vegan problem – the supplement options are just a little more limited, and if there’s nothing available where you are for whatever reason, I think the “do your best” clause we mentioned in the infant formula article would apply. This is also one of those areas where it’d be good to share what you’ve learned with non-vegan parents as well!

What about you? Have you found any products not mentioned here that could bridge the gap? Please share them (along with any other thoughts you might have) in the comments!

Thanks to Amy, Kari, Julie, Meredith, Kim, Monica, Doh, Erin, Elaine, Kelly, Rebecca, Kristie, Sylvia, and Dalyn for their help with this one!

Update May 6/2010: Lisa Tweeted Angela with a reminder about the Toronto Vegetarian Podcast’s interview with Brenda Davis about vitamin D – I haven’t had a listen yet, but they’re good people.

Update Aug 28/2010: The Health Canada link has changed.

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