Vitamin D: Vegan Pregnancy & Breastfeeding Series part 1
Updated: May 15, 2019
Vitamin D helps your baby absorb calcium for the healthy development of their bones. Inadequate vitamin D has been linked to muscular-skeletal conditions at varying stages in life and there are certain groups of people who have been identified as being at a greater chance of deficiency, including pregnant and breastfeeding women.
A childhood bone condition called rickets, although extremely rare in the UK, saw an increase from 0.34 to 3.16 per 100,000 children over a decade (1990s-2000s) (Goldacre, 2014). Although subsequently rickets has not been linked specifically to a vitamin D deficiency the rate of increase led to the UK Medical Officer calling for a vitamin D supplement for all children under 5 years old (Vitamin D Council, 2014)
Where is Vitamin D found?
Vitamin D hangs around quietly in our body until we are exposed to Ultraviolet B (UVB) radiation from the sunlight. UVB activates Vitamin D so it can work in unison with calcium. As I am sure you can imagine, in the UK we have a limited amount of UVB sunlight and many of us make a particular effort to avoid it because of the links to skin cancer. To make things more complicated it is impossible to know how long we need to spend in the sunshine to maintain adequate levels. Various studies have suggested between 5 and 30 minutes a day.
The best plant-based source of vitamin D is mushrooms. And if you leave those mushrooms to sunbathe before you eat them, you will consume approximately 25mcg (Keegan et. al., 2013) - but note it was difficult to identify just how long you need to leave them in the sun or how many mushrooms you need to eat to consume those amounts.
Who does it affect?
The Scientific Advisory Committee for Nutrition (SACN) conducted a review in 2016 which identified particular groups of women and babies who were at a higher chance of having a Vitamin D deficiency. These included:
Pregnant and breastfeeding women
Mothers and babies with darker skin types
Mothers and babies with minimal exposure to the sunlight (wearing clothing that covers arms and legs, using suncreams, spending a lot of time indoors, babies born in the winter months.)
Babies of mothers with a raised body mass index
Babies of mothers with diabetes
What are the recommendations?
SACN's review led to a recommended daily supplement of 10cmg for all pregnant and breastfeeding women. Supplements may be available on prescription if you are pregnant/breastfeeding and have an additional factor that puts you at a greater chance of having a deficiency.
The data in the review was insufficient to give a recommended does for children under 4, therefore a 'safe intake' is suggested of up to 10cmg per day. For babies under 1, vitamins are available in a liquid form. If you choose to give this supplement to your baby it can be dropped on to the nipple so baby can consume whilst breastfeeding, or given with a sterile spoon (the droppers included with the vitamins are notoriously difficult to keep sterile). If formula feeding, the supplement levels are met in formula milk if baby is having over 500mls a day. Otherwise supplement as you would for breastfeeding.
Do I need to supplement in pregnancy?
A new-born baby’s vitamin D status depends on their mother’s vitamin D status during pregnancy” UNICEF, 2017. Equally, the vitamin D levels found in your breastmilk are directly related to your own intake and stores of vitamin D. You can request a blood test through your midwife or GP to check your vitamin D levels and use this information to inform your decision to supplement or not, coupled with assessing your own perception of how likely you or your baby are to be at a chance of having a deficiency.
What impact does this have on my vegan pregnancy?
Because Vitamin D is primarily synthesised by the sunlight and we have already established that in the UK there is minimal UVB radiation, it is natural to revert to food sources. For vegans, these sources are limited to mushrooms and fortified products such as orange juice, plant milks and tofu (always check the labels for amounts). During your vegan pregnancy, simply consider your dietary sources and your likelihood of having a deficiency. It could be worth requesting a blood test to review your levels at the start of your vegan pregnancy.
Vitamin D3 supplements are often derived from lanolin, which is wax secreted from the sweat glands of wool-bearing animals. You can read bout this in my Vegan Pregnancy blog Common Medications and Products. Vitamin D2 is not normally derived from animal products.
Vegan Pregnancy & Breastfeeding Series
About Lisa-Marie South, Independent Midwife
I am a private midwife offering midwifery care in Cambridgeshire and the surrounding areas. Please feel free to contact me for more information about my private midwifery services, which include private antenatal and postnatal care, homebirth, birth advocacy, individual antenatal classes and birth debrief.
Goldacre, M., Hall, N. & Yeates, D. (2014) Hospitalisation for children with rickets in England: a historical perspective. The Lancet. Available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960211-7/fulltext
Keegan, et. al. (2013) Photobiology of vitamin D in mushrooms and its bioavailability in humans. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897585/
Scientific Advisory Committee on Nutrition (SCAN) (2016). Vitamin D and Health. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/537616/SACN_Vitamin_D_and_Health_report.pdf
UNICEF (2017). STATEMENT ON VITAMIN D SUPPLEMENTATION FOR BREASTFED BABIES. Available at: https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2017/01/Vitamin-D-supplementation-for-breastfed-babies-Unicef-UK-Statement.pdf
Vitamin D Council (2014). Rate of rickets in the UK highest in 50 years. Available at: https://www.vitamindcouncil.org/rate-of-rickets-in-the-united-kingdom-highest-in-50-years/#.W_rnBS2cZ8e
*Rickets is a condition that affects bone development in children. It most commonly presents between 3 and 18 months f age, causes bone pain and soft bones which can lead to cone deformities. More information on rickets can be found at: XYZ