Is Vitamin D Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Vitamin D? Is Vitamin D safe for nursing mother and child? Does Vitamin D extracts into breast milk? Does Vitamin D has any long term or short term side effects on infants? Can Vitamin D influence milk supply or can Vitamin D decrease milk supply in lactating mothers?

Vitamin D is a normal component of human milk. Daily maternal vitamin D supplementation in the 400 to 2,000 IU range produces milk concentrations that are inadequate to deliver the daily requirement to an exclusively breastfed infant, and inadequate to correct pre-existing infant vitamin D deficiency through breastfeeding alone. Breastfeeding mothers who take vitamin D supplements in this range should give their infants a daily vitamin D supplement of at least 400 IU to meet pediatric nutritional guidelines.[1][2][3][4][5] Daily maternal vitamin D dosages at or above 4,000 IU achieve milk levels can potentially meet the daily infant goal intake of at least 400 IU, depending on the mother's underlying vitamin D status and daily infant milk intake. Obese mothers may have higher requirements. Holder pasteurization decreased median levels of the major forms of vitamin D in breastmilk by 20% in one study.[6]

Maternal daily doses of 400 to 6,400 IU have not been associated with any short-term biochemical abnormalities in breastfed infants.[16][20][34][35][37][39][45] An 11-day-old, exclusively breastfed, term, female neonate experienced asymptomatic, mild hypercalcemia (total serum calcium 11.4 mg/dL). The mother was taking maintenance vitamin D2 100,000 IU daily to maintain normal calcium and phosphorus status after a pre-pregnancy thyroid-parathyroidectomy, plus a prenatal vitamin containing 400 IU daily vitamin D (form not specified) during pregnancy and lactation. Vitamin D2 and 25-OH-vitamin D2 levels in cord blood and in milk at 14 days of age were both markedly elevated. Serum vitamin D levels were not measured in the infant.[31] The combination of high daily breastmilk vitamin D2 intake plus a high infant serum level present at birth likely contributed to the abnormal calcium value. In a study in India, short-term maternal use of oral 60,000 IU vitamin D3 once daily for 10 days beginning after birth was not associated with any differences in serum calcium or phosphorus levels, or of urinary calcium/creatinine ratios, in their exclusively breastfed infants at 14 weeks and 6 months of age compared to infants of mothers given placebo. Infants of mothers given vitamin D had a lower frequency of biochemical rickets compared to placebo (0 vs 17%), but no difference in the frequency of radiological rickets (3.6% vs 3.4%).[44] In a pilot study measuring the epigenomic effects of maternal vitamin D supplementation on the mother and infant, ten women were given 3,800 IU or 400 IU of oral vitamin D3 once daily beginning at 24 to 28 weeks gestation and continuing through 4-6 weeks postpartum. Gestational age at birth was not reported but presumed to be term. All infants were fully or partially breastfed. Those partially breastfed only received an average of about 10 mL formula daily during the study period. Methylation of cytosine-guanine dinucleotides in infant leukocyte genomic DNA were significantly different between the two groups.[46] Since two out of three infants in the low-dose group received postpartum vitamin D supplementation and five out of seven in the high-dose group did not, larger controlled studies are needed to determine the effects of vitamin D exposure through breastmilk on the infant epigenome.