Transcript:
This is Maureen Farrell and Heather ONeal. And this is the Milk Minute an inclusive evidence-based podcast. Hosted by midwives and lactation professionals. Thatâs us! Here to talk to you about all things, lactation and boobs, body positivity, mental health, all the milky topics. Join us for another episode.
Welcome to the Milk Minute! Today, we are going to talk a little bit about vitamin D. Yeah. Today weâre going to talk about the D. Not the D youâre thinking of you pervert, the vitamin D. The one that comes from the sun. Yes, we are like plants. We take the things that the sun gives us, and then we turn them into magical vitamins that we use to make our bones strong.
So thatâs basically what vitamin D well, thatâs originally what we thought vitamin D did, but itâs been shown to do many other things and prevent many illnesses. Yeah. Itâs great for your immune system. So, side note, just cause, you know, weâre all still concerned about COVID and everything. If you do supplement with vitamin D, we have some preliminary research showing that you might do better if you get COVID so you should probably all be supplementing with it anyway.
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Letâs start with the bad shit that can happen if you. Donât have enough vitamin D cause thatâs fun to know. Yeah. Well, I guess we could even back it up a little bit before that, and we could remind people about our âHistory of Formula Episodeâ and what we discovered was that because they were not putting vitamins and minerals in the original form of formula, all these kids were getting rickets, which is where your bones are really soft and they in your legs bow. Itâs really awful. And basically, youâre left with a bunch of deformed children. And so clearly that upset people and they were like, we should start paying attention to how important vitamins are in our life.
So, I think thatâs the basis of where the interest in vitamin supplementation began. Yeah, and I guess to bring us to the present here, humans, theoretically, should be able to get enough vitamin D from the sun and from the foods they eat, because a lot of fruits and vegetables grown in the sun have vitamin D in them.
But most of us, especially in the Northern hemisphere or people who work inside or just basically donât spend their whole day outside, weâre vitamin D deficient. And also, people with darker skin. Yeah. You know, I honestly spend several hours a day outside almost every day and Iâm still vitamin D deficient.
Iâve had Amish and Mennonite clients who spend their entire days outside, still be vitamin D deficient. So, this is very common. And if youâre one of those people, whoâs like, oh, but not me. Maybe just get tested and see. Yeah. I mean, okay, so this is where you start to lose me because I am such a fan of the human body and nature. And nature so far has really figured out most things.
You know what Iâm saying? Like, we tend to try to over fix things that arenât really broken in the medical community much of the time, but also, is it a big deal? You know, like, is it natural for us to maybe not have that much vitamin D? Is it natural for us to not be able to process it⊠the way we feel like we should process it? Like shouldnât nature have fixed that by now?
But then the other side of me gets it, you know? Cause weâre not outside a lot. Most of us are inside with fluorescent [00:05:00] lighting and not eating the best foods. So, I donât know. What are your thoughts on that, Maureen?
I mean, Iâm there with you. I totally feel that. And a couple of times in the past few years Iâve been like, Iâm going to really dig into this and figure it out. And the reality is we donât have that answer. And you know, I did read some interesting research that mentioned how our bathing habits and our skincare habits might have something to do with it as well, because itâs not like weâre out in the sun, bam, we have vitamin D. So, we have this like precursor to vitamin D that we get from the sun and then our body uses that to synthesize it. But if we wash our skin too soon, we donât have that precursor. What? Yeah. So, the people who shower like three times a day, or like they go for a run and immediately hop right in the shower, you might not be making vitamin D from that sun exposure.
Thatâs interesting. Yeah. And that at least like clicked one thing in my brain for me, where I was like, oh, itâs actually only very recently in human history that weâve been bathing this much. Maybe that is it. Like maybe nature has figured it out, but we just keep jacking it up. That makes sense.
Yeah. I mean, thatâs my assumption with this whole issue is that probably if we actually consistently ate food that had enough vitamin D in it, because it was grown properly and we consistently spent enough time in the sun and we didnât like cover our skin in weird products and shower six times a day weâd probably be fine, but the reality is most people donât do that. And like, I donât know that we actually have data and testing from communities that do live more like that. So, I donât know.
Well, and also itâs important to mention that there are a few dietary sources of vitamin D, but theyâre not significant enough to provide the actual amount of vitamin D that we really need to function and prevent disease processes and, you know, prevent osteoporosis and all that.
So those foods are Cod liver oil. Delicious. Fish such as mackerel, tuna and salmon, egg yolk, beef liver, and four to five dairy products. So, most of us arenât running around eating and drinking Cod liver oil and all of these large ocean fish. So, the government, our government at least has put a lot of these vitamins into random stuff like cereal, like, oh, Americans eat a lot of, really piece of shit cereal⊠letâs just put folic acid and vitamin D in that. And then, you know, weâll solve all their problems for them.
Yeah. And really, I imagined when most humans had a much more significant portion of their diet be vegetables and fruit that grew outside⊠we also got a significant amount of vitamin D from that, but really, at least in this country, you know what I think of as the SAD diet, the standard American diet is abysmal like kids whose daily serving a vegetable is ketchup⊠Iâm sorry, that does not have vitamin D in it, but like tomatoes that you grew in the sun and sun dried, they have vitamin D. A lot of mushrooms have vitamin D especially when you dry them in the sun, which is interesting.
But again, itâs just like, nobody eats enough of that anymore. Yeah, thatâs true. And you know, I guess another thing to say about trusting our bodies, our bodies are set up to make very large amounts of vitamin D through sun exposure. So, in 24 hours, your body can fabricate 10,000 to 20,000 international units of vitamin D.
And thatâs only with like, 15 to 20 minutes of summer sun exposure in a bathing suit, or if youâre a darker skinned 45 to 60 minutes in the sun and then your body makes all that wonderful vitamin D. But because we use sunscreen now, because we are obsessed with skin cancer and not getting it. Which is reasonable, but also, yeah, maybe, maybe not. I donât know.
If you really look at the research on that also sunscreen since weâve started using it has not decreased the amount of melanoma that we are dying from. Well, there you go, folks. So yeah, maybe just getting in the sun. Now I donât feel so bad about the fact that I never wear sunscreen.
I really donât either. I think that the majority of people are concerned mostly about wrinkles these days. Like I donât want to get wrinkles. I didnât even think of that. Thereâs sunscreen in all of our makeup products. Did you know [00:10:00] that? I donât wear makeup, but I did know that. Thatâs why I said it condescendingly, like, did you know that you non-makeup wearer?
I donât know. The only time I wear sunscreen is when Iâm like, I know Iâm going to have direct all day long sun exposure and I am going to get burned and itâs going to suck. Right. Thatâs like the only time I put it on my kid too. And Iâm like weâre literally going to be under the sun nonstop.
Right, and if you canât get away from it then, yes. So basically, our bodies are very efficient at making it, but are we able to absorb it through food? Are we able to actually get it into the breast milk is a different story. So thatâs where things start to get a little bit sticky. Itâs like, yeah. If it was just us, weâd say go lay in the sun every day. With just a bathing suit on and absorb it. Thatâs great. But then the problem is getting it from that, into the breast milk and then into your baby.
Yeah, and I really used to be that provider that was like, just spend more time in the sun and spend time in the sun with your baby. But the reality is that I realized people donât do that even when I recommend, they do.
And, you know, we just⊠weâre missing some part of the research here as to why that doesnât seem to work for everybody. Yeah. If thereâs one thing that I can definitely say about doing this research, thereâs a lot of holes. Thereâs a lot of repetitive information and then thereâs a lot of holes as to like, okay, why?
Like go deeper⊠we need that next level of research now. Yeah. I want to know like, is there some heavy metal that we all have, you know, a high amount of thatâs jacking up this process. Is it some toxin weâre all exposed to? Is it like weâre eating too much of some kind of processed food? Like, I donât know, but thereâs got to be something thatâs messing with this process, but thatâs probably also a huge pain in the ass to set up a randomized trial about.
Right. And then, so thereâs that piece, but then thereâs also the, why is it important? Because so far, the only thing that they have for sure found is that if you do not have enough vitamin D in your diet, you. And your baby can get, or your baby mostly can get rickets, but then you can have of osteo-malesia.
Yep. So, and yeah, they did find like this was the only hard number that I found was that approximately 10% to 20% of extremely low birth weight, infants have radiological evidence of rickets with metaphyseal changes. Despite current nutritional practices. So, itâs worse for premature babies. Theyâre not able to absorb as much vitamin D as full-term babies.
So that was really the only hard evidence I found something else that said anecdotally, which means, you know, just what people say, and then as a correlation study, which is not the strongest evidence, itâs like, oh, we have evidence to do another study. Right. So, hereâs the evidence that we have to do all these other studies.
There have been correlations found between vitamin D deficiency and cancers, specifically of the colon, breast and prostate, hypertension, diabetes â both type one and type two, and multiple sclerosis, rheumatoid arthritis and other auto immune conditions. So those are like all over the map. Itâs like, basically itâs correlated with your bodyâs falling apart, but why?
So? Like, we need more, thatâs the next piece that I want. And hereâs my anecdotal piece in the practices Iâve been a part of that test for vitamin D deficiency prenatally, when people are still vitamin D deficient close to labor, we see more dysfunctional labors. And thatâs not a big study, but again, anecdotally, Iâve heard that from other providers who actually bothered to test for vitamin D levels.
And I think itâs been significant enough and you know, the data that we see otherwise about, you know, the potential harms and also the lack of potential harm from supplementation, you know, just makes me really recommend to people that they supplement, at least during their pregnancy and while theyâre breastfeeding.
You know, it seems like this is probably the best thing that we can suggest. Well, you know, thatâs interesting that you say that because the US National Institute of Health reports that 81% of women of childbearing age have insufficient levels of vitamin D. And so thatâs the US, right? And in the US, we have some of the most dysfunctional labor, we have some of the worst statistics.
So, Iâm not saying that vitamin D supplementation in pregnancy is going to fix all of that, but it sure is a good, easy [00:15:00] place to start. I mean, what could happen? You know, itâs pretty rare that you can intoxicate yourself on vitamin D. Right. And I think that honestly, it would be so easy to set up a study that at least collects data for this⊠where we just say, okay, weâre going to add one prenatal test to the panel because most people, if they birth at a hospital, they have their blood drawn at least twice. Right? So weâre going to say first trimester blood screening, weâre going to add vitamin D levels, third trimester, weâre going to add vitamin D levels and just then create this data set of vitamin D levels and, you know, outcomes of labor and see what comes up with from that.
Yeah, that would be really awesome. And then also some research did come out a couple of years ago. I think it was from Pittsburgh⊠somewhere in Pittsburgh that linked very strongly, vitamin D deficiency and chronic vaginitis.
So, which makes sense because, you know, vitamin D is a huge player in your immune system. And when your immune system is messed up your vagina, which is like this amazing place of natural flora and your microbiome at its best is affected. And then you start getting like, Iâm just chronically itchy, or I just have this weird smell or, you know, sex is weirdly painful all of a sudden and I donât know why. So, you know, then we draw vitamin D levels and low and behold itâs less than 20 and weâre like, ooh.
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I guess we should probably tell people what the normal levels are. So yeah, deficient is definitely less than 20. We like to see it above 32, somewhere in between there weâre recommending supplementation. Right, Maureen? Yeah, usually I recommend supplementation if I see something below 25, I say to definitely supplement.
If someoneâs closer to that 30 mark. You know, Iâm like, well, thereâs no harm in supplementing, you know, but you can take this low dose. Weâll retest, if you want to, it kind of depends on the client. Some people are more than happy to throw an extra gummy vitamin at themselves. And some people just really hate taking supplements. So, you know, I donât really push it unless theyâre super low.
Right. If theyâre low and you can see it, like theyâre fatigued, and they have chronic vaginitis and theyâre sick all the time. And you know, then itâs like, okay, this is affecting your life. So, Iâm sorry that you hate vitamins, but like, do you also hate being tired and sick all the time?
Right. And the reality is a lot of people take a multivitamin. Theyâre like, well, thereâs vitamin D in there, but itâs only like, 200 IUs or 400 IUs and itâs recommended most adults take closer to 2000 IUs per day. And so, me with my level of 22, Iâm taking 5,000 a day now. Yeah, I think I did 5,000 during pregnancy every day.
And we recommend that you start supplementing yourself in pregnancy because your baby will be born ahead of the game, like at normal, because your baby can be born deficient in vitamin D if you are deficient in your pregnancy. Yeah. And like, you know, youâre already so sick and tired in pregnancy.
So, I think you need to give yourself the best chance you can at, you know, not feeling miserable through that experience and vitamin D really people do report that they feel better when they have enough vitamin D. Yeah, they do. I mean, I can say that I have stopped my vitamin D supplementation. Why? I donât know.
I donât know why it just. I just stopped. I do that too. Iâm like, that vitamin, that, you know, the bottle fell behind the counter and now Iâm not going to buy a new one for the next year. I definitely felt better when I was on it and I went off of it and got coronavirus. So, you know, there you go. Lesson learned; lesson learned.
[00:20:00] So we need to talk about the American Academy of Pediatrics, actual recommendation for your infant. So, you know, weâve kind of covered, weâve discussed it. Weâve covered what the recommendation is for us as adults, to take at least somewhere between 2000-6400 international units a day.
But the American Academy of Pediatrics recommends supplementing your baby with 400 international units per day of vitamin D beginning in the first few days of life. And then continuing through childhood. And thatâs, even if youâre supplementing with a little bit of formula, they are still recommending this.
And honestly, I didnât know that. I thought that if you were having any formula, then you were getting plenty of vitamin D. I am wrong. So, I feel like if I didnât know that you all probably didnât know that. So, you know, it seems like youâre interrupting a natural process, but really, youâre not, youâre kind of just enhancing the natural process thatâs already there as a just-in-case measure and also to set your baby up on the right track. So, they donât become an adult whoâs chronically deficient.
Yeah. And itâs actually recommended to consider an even higher dose if you live in the farther Northern reaches of our world, or if your baby is very low birth weight, or dark skinned. Yes, or dark skinned as well. And when we are talking about very low birth weight, weâre talking very low. So thatâs less than like 1500 grams, which is what, how many pounds. Three, four, something like that. Yeah. Itâs small. So, this isnât, you know, thatâs not like, oh, my baby was six pounds⊠itâs small. Thatâs a normal size. Just FYI. Not every baby has to be 10 pounds, but yeah, those really small babies, theyâre typically very premature. And usually, you know, the hospitalâs going to take care of that, but if youâre taking your baby home from the NICU, you want to make sure that, you know, how much of that supplement you need to be giving.
And can I just give a little tip here? Because I was a nurse in the NICU for a while and we had to give the vitamin drops to the babies and the vitamins that we gave the babies there were all the vitamins, you know, it wasnât just vitamin D it was like these babies need all the vitamins and the iron, and itâs disgusting. Itâs liquid, and it is just the worst smell. I mean, it was horrible. So, my first time giving this vitamin, I just tried to shoot it right into the babyâs mouth, which it drank. And I was like, perfect. And then five minutes later, the projectile vomit that came up. With this vitamin was just⊠it was yellow. It stunk. And the baby looked at me like, âyou stupid idiot that was the worst thing ever.â And I felt so bad. So then one of the kinder, older, more experienced NICU nurses pulled me aside and she was like, honey, let me show you how to do this. So, the vitamin D drops probably arenât going to be as nasty tasting as what I gave, but if you have a baby that is a little bit picky, this is what you can do. You can either hand express a little bit of your milk, or if you already have some expressed milk, you can just take like five CCs, not even that much and mix it with the vitamin drops and cup feed it to them and then follow with a breastfeed.
Or bottle feed, whatever you do. But that way I donât recommend putting the drops in a big bottle, because if they donât like the taste, then they then youâve wasted that whole bottle. So, you only mix it with like five CCs, just a little tiny tablespoon, and then you can wash it down with a nice, delicious booby or a nice delicious bottle untainted by the vitamin drops.
And so, you know, some people will try to like sneak in with the syringe while the babyâs on the breast. I donât like that because it will drip out a babyâs mouth. You wonât know how much baby is getting, and you can create an aversion at the breast. You donât want them to think that every time they get to the breast, itâs going to be like that because then theyâll start trying to reject it.
So, you donât want to create any behavior issues there. So definitely just cup feed it or spoon feed it with just a little bit of your milk mixed in. Or, the other thing that you can do is take it yourself. So, this is another good option. If you donât want to just give your baby the drops, you can take a higher dose of vitamin D.
However, we want you to get a baseline, first of where your vitamin D is. So, you know how much to supplement. Yeah, and any doctor can do this. Itâs the test is usually covered by insurance, but itâs not cheap if you have to pay out of pocket. So, [00:25:00] definitely make sure that itâs covered before you get that.
And I donât believe the American Academy of Pediatrics technically recommends it, but we have a lot of good data that shows that maternal supplementation does provide babies with enough vitamin D through breast milk. Yes, but you have to have at least 6,400 international units. Right.
So, you do need to be supplementing a lot. These days you can find gummies that are like 5,000 IUs each, so itâs not hard to do, but itâs just something that you should probably make sure you that youâre good at taking your vitamins every day. And you know, you kind of have that under control. Hereâs my question though⊠and when I was reading over a lot of these studies about, thereâs a lot of studies that indicate that infants who are exclusively breastfed are at a high risk for vitamin D deficiency. However, Heather, did you see that if any of those actually reported real impact on those infants from that deficiency, the way that it did with like the very low birth weight infants? No, I just kept seeing rickets come up over and over and over again, which yes, we get it, we know that, but it has to be very severe. Well, I take that back, I did come across a study that said that if your child is born deficient with vitamin D and continues to be deficient through childhood, you will see an increase in respiratory illness in that child compared to other children who do not have deficient vitamin D. So, I mean, thatâs an immune system thing.
Yeah. I mean, thatâs significant for a lot of people, especially when, honestly, itâs like, especially when your babies are born during RSV season and during the global pandemic where weâre dealing with a respiratory illness like thatâs a real thing to consider for sure.
Yeah. I mean, having had Corona virus, if I had known a month ago to start taking my vitamin D again, you better believe I would have done it. Cause it was no picnic. Itâs still not a picnic. Iâm in my cheetah bathroom right now, mustering all the strength that I can to get fired up about vitamin D right now. Like, what the heck?
You know, Iâm going to be real here, guys, when Iâm talking about those clients, who donât like to take supplements and Iâm actually just talking about myself here⊠also people I work with, but like I fit into that demographic. I really, until like the last two years was so anti-supplements, I was like, I can get everything from the food I need eat and blah, blah, blah. But also, then I did a lot of research into how deficient our soils are in vitamins and even like the soil on my farm, you know, has vitamin deficiencies, the soil on the farm that I get most of my food from, you know? Iâm one of those people who gets almost all of my vegetables from a local farm, and yet still I have to supplement because all of our soils here are deficient and the things that we need from really poor growing practices for the last hundred years. It sucks, and I finally came to terms with that. I take my vitamins. Yeah. I definitely need to start again. So, I will make a pledge that I will start supplementing with vitamin D again.
Now this is the second pledge that Iâve made on the podcast. The first one I did complete, I watched Hamilton and I have to say it was very good. The first 10 minutes I was confused, and my brain was working really hard because I did not really know what to expect. And honestly, itâs been so long since Iâve studied the revolutionary war era that I just was like, my brain was just digging stuff back up from second grade. I was like, what? Yeah, youâre like social studies come back to me! Yeah, I know itâs in there somewhere, but then I was fully committed by like 20 minutes in. I was like, I donât know what this is, but thank God someone did this. This is great. Thank you. Lin-Manuel Miranda for doing this for us. Nobody asked for it, but we needed it. Exactly. So, if you havenât seen Hamilton, I highly recommend it, make it through the first 10 minutes and get through the brain cramp and then you will be very satisfied, very satisfied.
So, should we summarize really quickly? Cause I kind of feel like weâve thrown a lot of numbers out there. So, let me just do a quick little summary. We are pro-supplementation for vitamin D either in baby or through maternal side. So, if itâs, if youâre going to take it yourself as the lactating parent, we recommend taking about 6,400 international units a day.
Babies [00:30:00] on average should take 400 international units a day, if youâre supplementing the baby directly, unless you live in a place where there is much less sunlight or your child is darker skinned, and then you might have to bump it up to⊠what was it, Maureen? So that actually wasnât super clear. It said 600 and some places, some places that said other numbers, but 800 to a thousand in Europe, the European Society for Pediatric Gastroenterology recommends vitamin D of 800 to a thousand international units a day for preterm infants. Okay. So somewhere between 400 and a thousand. Yep. Fine. Whatever.
Sorry. So, thereâs that super clear summary for you guys? Yeah. Super clear. So, go be like me and go order your vitamin D and start taking it. And do let us know if your vaginaâs better or you just have more energy or if you just feel better. Yeah. Iâm going to go take my vitamins after this. Cause I havenât done it yet today.
Yeah. Well, thank you so much for listening to our rant about vitamin D. I hope you all learned something, and I hope it was clearer than mud. Bye guys. Bye.
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