Are Vitamin D supplements necessary for breastfed babies?

Recently received from LLL:

Q: I received an email from a Canadian based Baby Centre which said
that breastmilk doesn’t contain enough vitamin D and that breastfeeding
mothers should give vitamin D drops starting at 2 months of age. Is
this necessary?

A: It is generally agreed that vitamin supplements are unnecessary for
almost all healthy, full-term babies. Human milk was designed by nature
for the special needs of the human baby. It contains all the nutrients
a baby needs in the ideal proportions.

It’s quite true that human milk does not contain enough vitamin D in
itself to prevent rickets. (Rickets is a potentially life threatening
disease caused by insufficient sunlight exposure). However, most
exclusively breastfed babies are still not at risk of rickets because
they get enough exposure to sunlight and this results in adequate
vitamin D synthesis in the body. Just a few minutes of sunshine per
day is all that’s necessary.

At greatest risk for vitamin D deficiency are those who have one or
more of the following risk factors:

*Dark Skin
*Consistent coverage of the skin with clothing or sunscreen when
outdoors
*Live in areas where there is little sunlight for parts of the year or
do not
go outdoors
*Live in areas of heavy air pollution, which blocks sunlight
*Mother if vitamin D deficient

It is believed that more cases of rickets are being seen because dark
skinned mothers of African descent have migrated to cold, dark northern
climates. These mothers may traditionally cover much of their body, so
they get very little exposure to the sun. That wasn’t a problem in
their home countries where the sunlight was intense, but in the darker
climes of North American and North Europe, where winter sunshine is
frankly... minimal, they may not get enough for their bodies to make
the required amounts of vitamin D. Also, in other populations, more
people are avoiding sunlight exposure by staying out of the sun and
using more sunscreen.

So the question being pondered by health agencies in some countries is
whether vitamin D supplements should be universally recommended for
exclusively breastfeeding babies or only those populations considered
at risk. Perhaps in Canada the government decided to err on the safe
side and recommend vitamin D for all babies.

So far, however, research shows that exclusively breastfed babies,
healthy, full-term infants from birth to 6 months who have adequate
exposure to sunlight are not at risk for developing vitamin D
deficiency or rickets.

(information taken from The Breastfeeding Answer Book published by La
Leche League International, Third Revised Edition &
www.lalecheleague.org/Release/vitamind.html).