Vitamin D in pregnancy, breastfeeding and breast milk
What it found
Breast milk holds too little vitamin D to meet a baby's daily need of 400 IU, and vitamin D deficiency is common in pregnant and nursing mothers.
The authors say infants should get a daily 400 IU supplement.
What they found
Studies in people
Low vitamin D common
Vitamin D deficiency in pregnant women and nursing mothers ranged from 24 to 77 percent in Western countries and 46 to 97 percent in Asian and African countries.
Breast milk vitamin D
The average vitamin D content in breast milk was 45 IU per litre, with a range of 14 to 88 IU per litre. This is too low to meet the 400 IU daily requirement for infants.
Maternal supplements help
Randomised controlled trials found that high daily doses of vitamin D in breastfeeding mothers, 6000 to 6400 IU, raised the vitamin D content of breast milk to more than 800 IU per litre.
Infant deficiency without supplements
In exclusively breastfed infants who did not get vitamin D supplements, the prevalence of deficiency ranged from 67 percent in Japan to 76 percent in Ohio, United States, and 82 percent in the United Arab Emirates.
Maternal and newborn levels linked
A meta-analysis found that more than half of mothers at the end of pregnancy and their newborns were vitamin D deficient, and maternal and umbilical cord levels were significantly correlated.
Supplement doses in pregnancy
Randomised controlled trials showed that 600 IU daily in pregnancy was not enough to reach sufficient maternal vitamin D levels, while 2000 or 4000 IU daily achieved levels above 30 and 40 ng/mL, respectively, without adverse effects.
What the authors conclude
“Vitamin D content in breast milk is clearly insufficient to meet the vitamin D requirements of the infant; therefore, infants fed exclusively with breast milk are susceptible to vitamin D deficiency.”
Also in their conclusions
- They say that exclusively breastfed infants should receive a daily oral supplement of 400 IU of vitamin D (cholecalciferol) during the first year of life.
- They note that as an alternative, exclusive maternal supplementation with high oral doses of vitamin D can increase the vitamin D content in breast milk and reduce the risk of deficiency in the infant, but this has not gained wide acceptance in practice.
- They advise that the high prevalence of vitamin D deficiency in pregnant women and the low content in breast milk are mainly related to changes in lifestyle, such as less outdoor activity, always wearing clothes, and often using sunscreen.
How it was done
Vitamin D deficiency is common in pregnant women and nursing mothers worldwide, and it has been linked to problems for both mother and baby. The authors wanted to review vitamin D metabolism in pregnancy and breastfeeding and the amount in breast milk.
They reviewed published studies on vitamin D metabolism during pregnancy, the prevalence of low vitamin D in pregnant and nursing mothers, the vitamin D content of breast milk, and current supplement guidelines. They also looked at trials of vitamin D supplements in mothers and infants.
What it can’t tell you
- This is a review of other studies, so it cannot prove cause and effect between vitamin D and health outcomes.
- The cut-off points for vitamin D deficiency and sufficiency are based on observational studies, so they cannot show what level is best for everyone.
- The long-term effects of high-dose vitamin D supplementation in mothers on infant health are not yet known from randomised trials.
Who paid
- Conflicts
- The authors declare no conflict of interest.
- Authors work at
- University of Navarra, Spain; Navarrabiomed (Biomedical Research Center), Spain; Navarra Hospital Complex, Spain
The paper
- Title
- Pregnancy, Breastfeeding, and Vitamin D
- Type
- ReviewThe authors read earlier studies and describe what they found. It isn’t a new study.
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Durá-Travé T, Gallinas-Victoriano F (2023). Pregnancy, Breastfeeding, and Vitamin D. International journal of molecular sciences. doi:10.3390/ijms241511881Free full textPubMed 37569256DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error