Well, that’s not really the question. But is there an amount of Vitamin D that a breastfeeding mom can take in order for the breast milk to contain recommended levels of Vitamin D for her baby?

There have been numerous studies confirming the fact that breast milk does not contain enough Vitamin D to meet the nutritional needs of an infant. Even in mothers who are still taking prenatal vitamins; there’s not enough that makes its way into the milk ducts. 

The American Academy of Pediatrics recommends that all babies should be given a daily Vitamin D supplement which provides 400 International Units (IU) of the vitamin. Yes, even formula-fed babies need it (at least until they’re consuming a daily minimum of 32 oz per day of a Vitamin D fortified formula)!

There’s been some new light shed on this topic, however. Some studies have suggested that lactating mothers who take 4000 IU to 6400 IU of daily Vitamin D, will produce an adequate amount of the vitamin present in the breast milk to meet the nutritional requirements of the infant. This is pretty awesome news! Especially if you’re like me and forget to give your little one their daily dose; or better yet, if your little one gives the Vitamin D right back to you (stained clothes or furniture anyone?). 

It’s important to note that the research noted that adequate Vitamin D levels weren’t reached until about 4-5 months AFTER taking the increased dose. 

With that being said, we still recommend that you give your baby a Vitamin D supplement until there is more research done in this area. I would also highly recommend that mothers who are interested in breastfeeding discuss taking an increased dose of Vitamin D with their OB/Gyn as elevated Vitamin D levels in the body can pose some health risks. 

I have moms in my office tell me all kinds of variations of the "I'm a bad mom statement" and it is always for minor things - still using a pacifier, let them have too much candy or still lay with them to help them sleep. I know a lot of this is looking for reassurance but I also think we do this to ward off mom-shaming. If I say it first then you can't shame me about it.

We live in a world where many small joys and achievements are shared online, but also in which we can see and judge each other's actions easily. This causes some of us to doubt our own ability and choices as mothers.

Maybe this doubt causes some of us to make other moms feel bad about choices that were not the same as ours. Maybe we want to shout loudly about the one thing we feel we are doing right and push away all the things we are doing wrong.

In either case shaming a mother is really a selfish act of making one person feel better at the expense of another - even when it is coated in words like "I'm just trying to help."

Moms often come to the end of a well child checkup and have one or two questions they feel they must ask to make someone else happy. Things like - "I'm not really worried, but my mom thinks hitting is not normal at this age" or "my friend says my child is not getting enough milk but I think it's OK, what do you think?"

One of things I love most about being a pediatrician is supporting parents to be the best parents they can be and affirming their skills and abilities.

Parents are showered with choices on how to feed, discipline and teach their children, and it feels like the "rules" or advice is always shifting. Thankfully for many things, there is no single perfect way to raise your child and anyone that tells you there is, is not thinking broadly enough.

Part of our job as pediatricians is to help you raise a healthy child. We will advise you on safety, health and what we have seen work, but we must also take into account different family styles that impact choices around feeding and sleep.

The "I breast fed for a year," "my 2 year old loves broccoli" and “my child slept through the night at 6 weeks of age" are all statements that are wonderful accomplishments of child rearing. But they can be also be used to shame other moms to feel bad about their own parenting.

I want to remind new moms, especially by the time your child is 10 no one will care about how you did any of these things. Your child will be wonderful because YOU are his or her parents.

And if you care enough to read this and ask your pediatrician questions then you are doing a great job already.

Both can be a self-destructive losing battle.

Guilt is a negative emotion and often unhealthy – it can make anyone unhappy, dissatisfied and unproductive. For parents, guilt comes in all forms and I can especially relate to working moms. After all, I’m one myself. According to AmericanProgress.org women make up half of the workforce in the U.S.

Care.com found that 80 percent of working moms feel stressed about balancing child care, work, home and relationships.

It's important to understand there are a multitude of reasons why a mom is in the workplace. Some women may be the sole or primary breadwinner, others work because they can't afford child care and some work because they know that working will help them be a better parent.

It's critical for us as women and mothers not to pass judgement, but rather be supportive of all working women regardless of whether they are an employed mom or a stay at home mom. All mothers are working mothers!

But for the purposes of this article, I will focus on helping employed moms feel better about their decision to work. Often that requires us to look at the definition of what being a good mother is - a good mother is not determined by the number of hours we spend with our children. It's more about ensuring our children that they are wanted, valued and loved.

Working moms, by their example alone, can teach their children the value of hard work, ambition, independence and self-reliance.

The struggle that many working moms ask of themselves, me included, is there a way to balance work and being a mom? While it's a challenge, there are some things that working moms can do to help.

1. First and foremost is to realize we can’t do it all! We absolutely have to let go of some things, especially the unrealistic expectations. It's important to identify every household member’s needs and obligations and to realistically prioritize them. By changing our expectations, we can change other’s expectations of us.
2. We are bombarded with “expert” advice on what we “should” do to be a “good parent.” The bar that has been set for defining what a good parent should do is often ridiculously high and unrealistic. It is critical to remember we do not have to have gourmet meals on the table every night to qualify that we meet the good parent standard. What is most important, as noted previously is to make sure our children know they are very much wanted, loved and valued.
3. We have to enlist everyone’s cooperation and assign responsibilities, even to our children provided they are developmentally appropriate. When our kids were of school age, my husband and I shared the carpool responsibilities, as well as household duties.
4. When we are with our children it's very important to be present and intentional with them. Remove or minimize distractions, be engaged and interested in them. Set aside special time with each child, even if it's a few minutes a day. My son who is a grown man still talks about our hot chocolate/coffee stops as I would take him to elementary school.
5. Create special family activities that nurture each other, but create activities that fit into your schedule and budget. This might be a family board game night, baking cookies or reading a book together. Children also deeply value traditions – creating your own traditions with each child and as a family are very important.
6. Working moms often feel guilty about working and want to make their children happy. Our goal as parents is to raise our children to be responsible adults, which means we set realistic expectations, we assign responsibilities and chores, we follow through with consequences and we teach life lessons.
7. Learn how to set boundaries and how to express those boundaries in a kind way. It’s Ok if you can’t attend every PTA or school function during the day. Communicate that you would love to help and then provide for them the manner in which you can help and in that communication, include your time constraints.
8. Forgive yourself if something does not get accomplished or completed in the manner you had desired. By accepting responsibility and being flexible you are setting an example for your child that we all make mistakes, but we need to be accountable and responsible for them.
9. Create time for yourself and take care of yourself. You will not be good for anyone if you do not take care of yourself.
10. Utilize resources and supports. One of your best resources and support systems are other mothers. Find a local support group on the web or create one with your friends and/or co-workers who can share tips with and/or ask for help and ideas. Find daycares/providers that will assist with homework. Share carpooling responsibilities with other parents. Hire trusted and competent high school or college students to help with facilitating transportation to other activities.

Consider all of these options to help relieve the stress and provide more quality time with your children.

Remember what is most critical is to ensure our children that they are wanted, valued and loved, while raising them to be responsible adults.

The numerous health benefits of breastfeeding cannot be denied. Some of them might be overstated at times but, all in all, I believe that breastfeeding is best.

I know there are times when, for whatever reason, moms cannot or choose not to breastfeed. Fortunately, we have come a long way from the old days of evaporated milk formulas of the 1920s to where formula feeding is a very reasonable alternative for those moms. I believe that families should be properly educated and supported in their feeding decision no matter what it is.

If you chose to formula feed or plan to, you can stop reading now. This is not one of those articles meant to shame someone for their choice. This post is a message in support of moms and families who choose to breastfeed and need a little help to determine if everything is going OK.

“Seven percent is average, over 10 percent I start to get worried.”

Most moms know (or read or were taught) that babies lose weight in their first few days of life. If not, that one week checkup is pretty emotional when they place their babies on the scale and the number is lower than their birth weight. Think about it, a 10-pound baby can drop to as low as 9 pounds and still be considered normal weight loss, but you would certainly worry from the time the baby was weighed until I came in the room to tell you everything is OK.

I have been quoting this 7 percent/10 percent mantra since I started practice. It’s partially wrong, at least for breast fed babies. Why? They can actually lose more and still be normal.

A study released in Pediatrics in December showed that breastfed babies could lose more than 10 percent and still be normal, especially babies born via caesarean section. The graphs enable a pediatrician to look at a baby’s weight loss day-by-day and determine if the weight loss is excessive. The bottoms of the weight loss peak occur on day six for both vaginal and c-section but the peaks occur at 11 percent and 12 percent respectively.

Why does this matter?

Any mom who has had trouble getting their baby to grow on breastmilk knows the pressure to start formula that can be applied by doctor, nurses or family members. While, I don’t believe that having mom give formula when appropriate ruins her chances of breastfeeding, I certainly don’t want to be pushing families to supplement when it isn’t necessary. Therefore, I plan to start implementing these guidelines into my practice so that I can best support breastfeeding moms in their effort to breastfeed.

If you are having a baby and are planning to breastfeed, it might be helpful for you to be aware of them as well.