Most mothers eat a varied diet with fortified foods (usually milk) containing Vitamin D, take prenatal vitamins, and have some exposure to sunlight while pregnant and have plenty of Vitamin D to pass on to their babies.

However, due to an increase in vitamin D deficient babies, the American Academy of Pediatrics published guidelines in 2003, recommending that all breastfed babies receive 400 mgs IU of Vitamin D drops each day.

The increased number of vitamin D deficient babies is likely due to the less amount of time today’s moms and babies spend in the sun. Darker skin tones, vegan diets, babies born in northern regions and those who cover completely (like religious veils) are at a higher risk for deficiency.

Talk with your child’s health care provider about vitamin D options for your child.

Related Topic:

• How Much Calcium and Vitamin D Does My Child Need?
• Do Your Kids Need Vitamins or Supplements?
• Let's Learn About ... Giving Your Kids Vitamins
• The life-saving reason your baby needs vitamin K

Often, moms perceive that they do not make enough milk because they do not make “extra” milk.

Other times they think the baby is eating too often, or the breasts feel too soft, or the baby is fussy at certain times of the day, or they are unable to pump much milk.

Many complain they do not leak, that their baby nurses quicker than he or she once did, or that they are unable to feel a letdown.

Reality is, that none of these things mean that a mom has inadequate supply.

As the virtual lacation consult at Cook Children's, I ask questions like:

• Is the baby is growing?
• Are they having plentiful output (poops and urine diapers) each day?
• Are they waking often to feed and seeming satisfied after?

Since breastmilk is easily digested, breastfed babies may eat more often than bottlefed babies at somewhere between 8-12 times in a 24 hour period. The baby will be described as alert and active, and seems satisfied after feedings; often times with relaxed hands. Mom will also report hearing swallows during the feed.

The greatest indicator of sufficient milk intake is weight gain, though an initial loss is normal and expected as they shed the extra fluid in their tissues. Once the milk supply is in, we expect most babies to gain close to an ounce per day. After 3-4 months, the number will gradually slow down.

Another reliable indicator is output. By day 6 we expect to have 6 pale and mild smelling wet diapers and >4 bowel movements that have transitioned to the yellow, mustard, seedy stools. Over time, the number of stools will fluctuate and breastfed babies may go many days without a BM as their body is absorbing all of the nutrients. Even then, we expect soft and profuse stools.

The older the baby gets, the more adequate they feed, therefor spend less time at the breast and since many mothers do not feel their letdowns, that nor the firmness of the breast tell us how well the infant is being fed.

Virtual Lacation Consultation Program

Connect to an International Board Certified Lactation Consultant (IBLC) from the comfort of your own home. When caring for a newborn, it is important to have support for successful breastfeeding and nutrition. Cook Children's now offers that to you and your baby when and where you need it: in the comfort of your home. Click here to learn more about the program.

Schedule an appointment now

Consultation topics include:

• Correct latching
• Milk supply
• Feeding schedules
• Pump options and supplies
• Pumping routines/schedules
• Return to work planning
• Nutrition and skin care
• Newborn positioning
• Milk storage
• Pain or possible infection

Meet our Lacation Consultant

 

Holly Erwin, LVN, IBCLC, is a mom of three boys and has worked as a pediatric nurse for over 11 years within the Cook Children's Health Care System. When not working, she spends her time running to and from sports for her boys, being outside with her family and dreaming of traveling with her husband of 10 years. For now, she settles for their bi-annual date-night!

Through her own children and the thousands of moms that she has helped over the years, Holly found a special interest in infants and breastfeeding. In 2015, she became internationally board certified as a lactation consultant and now works as an IBCLC virtually through the Cook Children's telemedicine department.

The first sign of breast development can begin as early as 8 years or as late as 14 years. Once breast growth begins it can be expected to continue through all the stages of puberty up to age 19. It is normal for one breast to be larger than the other, for one breast to begin growing before the other and to have mild breast tenderness as the breasts grow.

Breast growth is caused by hormones acting on the breast tissue with growth of milk ducts and fat tissue. Final breast size is influenced by a girls hormones and her genetics. Bras can be worn for comfort as soon as breast development begins, but a bra is not necessary for breast growth. Bras do not affect the final breast size. A "training" bra is just a name there is no active training that the bra does. There is nothing that can speed up or slow down breast growth.

Remember that every girl develops at a different time and rate and that there is no normal for breast development. Questions about puberty and breast development are perfect topics to talk to your pediatrician about at your well-child exams as early as age 8 or 9.

If you don’t know her name, you more than likely have seen her photo because she has blown up the Internet with a photo of her breastfeeding her own son and the son of a friend.

For some it’s a beautiful expression of what’s perfectly natural. For others, it’s caused a range of emotion from “yuck” to outrage.

And for our lactation experts at Cook Children’s, well, they look at it as an opportunity to educate the public.

The lactation nurses at Cook Children’s have been busy working and had not seen the photo making the Internet rounds until called for this story. They realize that it makes many of us uncomfortable in the United States to see such a bold expression of a natural process. But they say it’s a common practice in many other countries around the world and accepted and sometimes expected culturally.

From a medical aspect, the lactation experts say milk sharing is becoming a more common practice but not without risks. There are numerous transmittable diseases that can be passed on through a mother's milk as well as many medications that will be passed on through milk too. As milk sharing is becoming more common there are even websites out there where people can share breastmilk with one another. Again, caution must be used when sharing breast milk.

To be perfectly safe, for those babies that have a medical need and prescription for breastmilk, they recommend a place like Mothers’ Milk Bank of North Texas, which allows moms to donate breastmilk. The mothers go through a screening process and is then the milk is pasteurized to make sure there’s no harmful bacteria.

The consultants hope that people don’t focus on the photo as much as they do the benefits of breastfeeding.

And for those of you wondering, “Aren’t those kids a little old to be breastfeeding?” Come on. We know a lot of you are. The World Health Organization recommends breastfeeding babies until at least 2 years of age.

The lactation nurses aren’t willing to weigh in as far as the emotional aspect of the picture or how it impacts them developmentally. Breastfeeding in a personal choice and one that we hope every mother will attempt. How long to feed your baby is personal and will be very different for each mother. At the end of the day, breastfeeding is supported by the World Health Organization, Center for Disease Control, the American Academy of Pediatrics just to name a few.

The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of a baby’s life, “followed by breastfeeding in combination with the introduction of complimentary foods until at least 12 months of age, and continuation of breastfeeding for as long as mutually desired by mother and baby.”

About the source

Because research shows that breast feeding helps improve babies' health and helps moms bond with their little ones, Cook Children's has full-time lactation specialists on staff to assist mothers with pumping and breastfeeding. We offer breast pumps in every room and have an on-site milk bank available for safety and storage. There are numerous resources available through lactation services for moms that are having difficulty with nursing/pumping. While other nurses are focusing on the baby's care, the lactation consultant can provide extra attention to mom.