TORONTO - Pregnant women and nursing mothers should talk to their doctors about taking a daily supplement of 2,000 international units of vitamin D, the Canadian Paediatric Society said Monday.
The vitamin D intake mentioned by the pediatricians' group is significantly higher than Health Canada's current recommendation of 200 IUs for adults 19 to 50 years of age, which includes pregnant and lactating women.
Health Canada also released a statement Monday, saying that it believes a number of independent recommendations issued by various organizations on vitamin D are coming too soon.
"Health Canada believes these recommendations are premature and that a comprehensive review that looks at both benefits and safety needs to be undertaken before the department can issue a revised recommendation,'' it said.
Vitamin D deficiency can pose serious dangers to the development of a fetus and infant, yet can be prevented through taking supplements, the society argues.
The focus isn't just on preventing bone-disfiguring rickets these days because vitamin D can also help protect babies against other illnesses in childhood and later in life, it says.
"There are lots of studies that suggest that a lot of mothers, particularly aboriginal mothers in the north, have been vitamin D deficient,'' Dr. John Godel, principal author of the Canadian Paediatric Society's statement, said Monday from Quadra Island, B.C.
"And this means that the breast milk that they have is also deficient.''
It's the latest call by a major health or medical organization for Canadians to boost their intake of what's often called the sunshine vitamin. In June, the Canadian Cancer Society caused a stir when it suggested that adults consider taking a vitamin D supplement of 1,000 IUs daily during fall and winter, while darker-skinned and older people should think about taking the little white pills year-round.
Health Canada noted that it's aware of the growing body of evidence on the role of vitamin D in relation to health. But it also reminded Canadians that there are health risks associated with taking too much vitamin D and they should not exceed 2,000 IUs per day from all sources, including milk and supplements.
The department is working with the United States Institute of Medicine (IOM), which recently held a workshop looking at the process for updating daily recommended intakes, including those for vitamin D.
Godel said he suspects Health Canada will have to change its basic criteria.
"It's a bit of a problem because Health Canada has a big influence on what is recommended and given in native communities, particularly in the north, so that it might be difficult for a nurse in an outlying community to give 2,000 international units when Health Canada hasn't come on board with the higher dose,'' he said.
"So it's going to take a while.''
A lot of research has been done since the IOM last established recommendations in 1997, Godel noted.
Carol Wagner, a professor of pediatrics at the Medical University of South Carolina, is among those conducting research on vitamin D deficiency. She has been studying pregnant women for about four years and lactating women since 2001.
"We've really just found even in sunny South Carolina, where we live, a silent epidemic, especially in our darker-pigmented individuals,'' she said from Charleston, S.C.
"Why do we care about it? We care about vitamin D because it's not just about bones. It's about your innate immune system, your ability to fight infections, long latency diseases such as multiple sclerosis and cancers, all sorts of things like that.''
She said that 2,000 IUs "really is quite safe.''
"And to go through a pregnancy and be insufficient is really, I think, not the way to have a pregnancy progress.''
The Canadian Paediatric Society repeated its urging that babies who are exclusively breastfed receive a supplement of 400 IUs a day, and that babies in the north, above 55 degrees latitude, should get twice that recommended amount from October to April.
The society's statement also recommends that babies with dark skin, those who have limited exposure to the sun or whose mothers are vitamin D deficient also get extra vitamin D during the winter, no matter where they live.
Wagner said vitamin D intake could also be considered from the point of view of a per-kilogram basis.
"An infant who weighs three kilos gets 400 international units,'' she observed. "So you have a woman who's 60, 70, 80 kilos, who's only getting 400 and think about that per kilo -- it's really negligible.''
