Let’s Not Blame the Milk

Breastfed infants, as opposed to formula-fed infants, are at risk for vitamin D deficiency. While this is true, it’s important not to blame the milk. Here’s why.

Breastfeeding. It’s almost scary to write anything about it. There are women who feel bad because they do not or cannot breastfeed. There are women who do so and love it. There are women who do so and hate it. There are women who barely get through six months and women who adore nursing toddlers. There are women who are defiantly pro-formula and those who feel proud to have never given their child a drop of formula.

There’s a wide spectrum of options, and rarely does anyone talk about breastfeeding without emotional investment.

This emotional investment is understandable for a few reasons. First of all, we’re talking about how you feed your child in the earliest months of her existence. That’s no small matter. Secondly, it’s something that is (almost) exclusively an action of females. Women in particular are under intense pressure for their parenting choices. (A friend, a working dad, on the other hand, had his colleague proclaim the other day that “it’s so great he helps out” when he mentioned his son used the potty.)

And lastly, when it comes to breastfeeding, emotional and physical processes and stimuli are about as closely linked as they can get—a mother can actually leak just upon hearing her baby cry.

A completely detached, scientific, observational conversation about breastfeeding is difficult. If we recognize that as the case, though, we can improve the relationship between mothers and healthcare providers and perhaps make all women feel more secure in their choices.

In this post, we focus on one small aspect of breastfeeding and nutrition to explain how words matter when it comes to this emotional topic.

Breastfed infants, as opposed to formula-fed infants, are at an increased risk for vitamin D deficiency. While this is true, it’s important not to blame the milk. Here’s why.

Many doctors explain it to their patients in this way:

“Breastfeeding is recommended, but breastmilk is deficient in vitamin D. Your baby needs supplements.”

Let’s take a minute to analyze what this message conveys. While the point about vitamin D deficiency risk is scientifically accurate, the doctor has actually just told a woman who is keeping a tiny human alive with her own body that her milk is inadequate.

That statement can have significant consequences. Not only can explaining the issue in this rather cavalier way make the mother feel nervous, anxious, or deficient herself, it can also make her question all the effort she’s putting in to nurse her child.

Infants can eat for hours on end. Nursing is not a sometimes job. Moreover, with parental leave time as scarce as it is in the United States, nursing can be a ton of additional work since, for many, it involves a lot of pumping, freezing, storing, carrying, and justifiably crying over spilled milk.

Describing the potential for vitamin D deficiency as a problem with breastmilk has the potential to undermine the effort a mother is putting in to follow the American Academy of Pediatrics guidelines, which recommend:

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

In other words, the recommended way to feed infants takes physical and emotional dedication from people who might react negatively to the news that their milk and their effort are not enough. How medical professionals explain this risk is thus extremely important.

What is more, a 2015 study comparing maternal supplementation to direct infant supplementation indicates that blaming the milk is, in fact, an inadequate description of the problem.

The study, “Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial,” published in Pediatrics in September 2015, concludes:

“Maternal vitamin D supplementation with 6400 IU/day safely supplies breast milk with adequate vitamin D to satisfy [a] nursing infant’s requirement and offers an alternate strategy to direct infant supplementation.”

Furthermore, direct infant supplementation, the study states, is a “largely failed … strategy.” This is, in part, because the supplements are not easy to administer. It should also be noted that direct infant supplementation does not address deficiencies in the nursing parent.

If a breastfeeding mother has an adequate supply of vitamin D, therefore, her body will transfer adequate amounts to the milk that she produces for her child. This study demonstrates how important it is not to blame the milk—not only for the health of the mom and that of their child, but also for the sake of parents’ emotional wellbeing and sense of confidence in the already stressful period of new parenthood.

The problem, then, is a lack of vitamin D in people, not milk. In fact, it’s quite miraculous to think that as long as a woman has enough herself, her body puts that in the food it produces for her child. Instead of showing breastmilk to be deficient, it actually shows that it’s quite amazing.

It would be easy to infer from the risk of vitamin D deficiency that breastmilk is the problem. It is not. How doctors explain this potential problem to mothers can have significant effects on their feelings, actions, and even the way we understand breastfeeding in general.

What message would medical professionals convey instead if they told nursing parents that having an adequate supply of vitamin D will ensure that their baby does, too? When expressed in this way, medical advice could have the potential to bolster a nursing mother’s confidence while improving her health and that of her infant.

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