Showing posts with label vitamin D. Show all posts
Showing posts with label vitamin D. Show all posts

Friday, 2 October 2015

So you're breastfeeding dairy free... some things you may be missing out on!

Hello there, fellow dairy free Mum!

*Waves*

Who even knew that cow's milk protein could pass through your boob juice and into your baby, eh?? I certainly didn't, before 'Baby' turned up allergic to the stuff! Apparently, it's not that common - that milk proteins go though the breast milk - but it doesn't really help you much, does it??

How are you feeling today? Positive, upbeat, ready for a challenge? Or hanging on in there by the skin of your teeth and not sure you even want to carry on? 

It's alright. Either way, I won't browbeat you to carry on, the choice is always YOURS, but this post has been written with YOU in mind, to help you on your way! 


1) Some Encouragement

  • Well done for giving it a go, at the very least - not everyone who is faced with this challenge will (for whatever reason, but again no judgement here).
  • Some people might think you're a bit weird. Ignore them. It's nothing to do with them. This is between you and your baby! 
  • By going dairy free yourself, you will be well equipped to know which foods will be suitable for your dairy free child - should your bubba still be dairy free when it comes to weaning.


2) Calcium 

If you eliminate dairy from your diet as an adult, you need to make sure you keep an eye on your calcium intake. If you're a breastfeeding mum, you need around 1250 mg of calcium a day. Initially, I was advised to use a calcium supplement, but as I researched products and foods containing calcium, I began to take more control of my calcium intake through my diet. 

So for example, if a glass (roughly 200ml) of your dairy free milk substitute (unless it's organic) contains around a third of a normal person's daily amount of calcium (700 mg a day, so 250mg in a glass) then you can probably pretty soon work out ways of including that in your daily diet. For more ideas on how to get calcium through your diet, follow this link. But, if you are going to do things this way, make sure you stay on top of it and don't let it slide!


This orange juice is fortified with calcium


3) Vitamin D

Vitamin D is also important, because Vitamin D helps your body absorb calcium. Calcium supplements and most dairy free milks usually contain this already, but there are plenty of ways of obtaining this through your diet as well as through sunlight. If you'd like to know more, please see this post. 



4) Milk Substitutes

If you're going dairy free, you might be wondering what on earth you're going to do without milk. Don't worry, there are plenty of other options, all of which can be used in pretty much the same way as normal milk - although some have a few oddities! So, for example, although I generally prefer almond milk (I use unsweetened almond milk in my savory dishes), Koko coconut milk generally makes a better custard - just because it thickens better!

There are a range of milk substitutes out there, see here. They can be found in the longlife milk aisle or in the chilled section, alongside the milk, in most UK supermarkets. 


A range like this, will only be found in larger supermarkets.

Some notes of caution:
  • Most mammalian milk proteins are very similar, so if your child is allergic to cow's milk protein they are highly likely to be allergic to other mammal milks too (sheep/goat etc.) 
  • Lactose free milk has had the sugar removed, not the protein, hence it will still cause a reaction in those allergic to cow's milk protein.
  • A2 milk waffles on about different proteins, but cow's milk protein of any variety is unsuitable for anyone allergic to cow's milk protein. 
  • Rice milk is not advisable as a main milk drink for children under the age of five, so should also be avoided by breastfeeding mums. This is due to the levels of arsenic that naturally occur in rice. Personally, I don't consider this a loss, as I don't enjoy it. 
  • Organic dairy free milk is not supplemented with calcium or any other vitamins, so if you're relying on dairy free milk for calcium, just bear that in mind!

For a more detailed breakdown of the nutritional values of various dairy free milks see here.



5) Butter... well, OK, marg! 

Okay, nothing tastes quite like butter - you've got me there, but there are some passable margarines out there, which you can use in much the same same way as any other margarine! My personal favourite is Pure Sunflower Margarine - found alongside all the other margarines in the supermarket. 

There are others - Vitalite, Stork Block (not the tub version), and some supermarket 'own' free from versions too. There's a new coconut based margarine by Koko, which is stocked by some branches of Waitrose. I tried it out at The Allergy Show in London, and it was certainly palatable.



Marks and Spencer's version.

Beware of brands that are also made with sunflower or olive oil, but are not dairy free - there are some out there!



6) Cheese

Cheese was probably the one thing I missed the most, when I first went dairy free! If, like me, you love your cheese, you may not find your perfect substitute, but the one that most people seem to enjoy is Violife. 

These days the 'original' version can be found in major branches of Tesco, Asda, Morrisons and Holland and Barrett, as well as many Health Food Stores, and if it's cooked or toasted, I don't mind it too much! It does come in various other varieties too,(including Parmesan), but you may have to try online for these - check out Alternative Stores, for a wider range.

This one is very popular!

In the US, Daiya is the one to watch out for - I've heard it is now available in one or two places in the UK, so keep your eyes peeled, you never know!

Just remember that Vegan cheese does not have the same amount of protein as normal cheese. Its nutritional value limited, compared to 'normal' cheese, so I tend to use it for flavoring other dishes (e.g. sprinkled on a home made dairy free lasagna). Don't expect it to contain much calcium, either!

Vegan cheese does not melt in quite the same way as 'normal' cheese. It tends to melt better in sauces, but on pizza or toast you may be disappointed. Some mozzarella-type cheeses, like Mozzarisella, melt best and the Violife pizza version is pretty good too.

One last thing, some people like to use nutritional yeast as a cheese flavouring. You can buy it in Holland and Barrett or health food shops. It smells like well-worn socks and doesn't really do it for me! You have been warned!



7) Yogurt

If you're okay with soya, you will be fine - you'll be able to find Alpro soya yogurts in most supermarkets and a child-friendly fromage frais in Tesco. A good Tesco Extra is, quite frankly, best place I go for chilled dairy free subs, unless you get Ocado in your area, or live near to a good Vegan store, or a Health Store like Whole Foods Market in London. Holland and Barrett are fast catching up though - so if yours has a chiller, check them out too!


Familiarise yourself with the Free From section in the chilled aisle at Tesco.

If you can't have soya, look out for coconut yogurts like Koko (Tesco, Asda, Morrisons ad Ocado), Co-yo (Waitrose, Tesco, online with Ocado) or Pudology (Ocado and Holland and Barrett). Holland and Barrett also sell 'Wot no dairy?' long life yogurts, which are made with pea protein instead, as well as Xotic, which is also made with coconut, is and long life too.



My personal favourite! This flavour is sadly not available at Tesco.

Be careful though, there are some apparently  'dairy free' alternatives that are produced on the same line as milk products. They are often, annoyingly, placed alongside dairy free products and marketed the same. Read labels carefully. If your little one is as sensitive as mine has been, and you eat them, you run the risk of a reaction via cross-contamination.

Alpro's soya, Koko and 'Wot no dairy?' yogurts all contain calcium, but the Co-yo and Pudology do not!



8) Ice Cream

As the temperature outside begins to hot up, you may wish to cool down! Fortunately, there is plenty of dairy free ice cream out there - just don't expect to find it sold alongside your Mr Whippy! My personal favourites are sold in Waitrose and are made by Almond Dream, but my little one loves Swedish Glace, which is soya based and found in Sainsbury's, Waitrose and Tesco.

Sadly not available, when out and about!

That said, Tesco have recently hit the dairy free jackpot, with these gluten and dairy free cornettos. They're in the Free From freezer section at Tesco. I can highly recommend these!

If you're out and about, keep your eyes peeled for sorbet or Gelato - some of these are dairy free, but not all, unless you got to Boho Gelato in Brighton (new one opening soon in Weymouth)! Alternatively, if you're near a Holland and Barrett with a freezer section, you may be lucky enough to find a small tub, containing a single serving of Booja Booja ice cream (made with cashews). I've not tried it as I can't eat cashews, but I've heard its delicious!

Booja Booja mini tub

Holland and Barrett also sell Perfect World ice cream, also pocket sized and made with cashews.



9) Cream

Wimbledon is fast approaching and what are strawberries without... cream!? If you're okay with soya, there's quite a few soya creams out there, on the supermarket shelves, including a squirty one called Schlagfix. If not there's always Oatly or Alpro rice cream (okay, I know I said no rice milk, but that's on a daily basis, a little rice cream now and then shouldn't do any real harm). In Tesco and Waitrose, you can now also get a small carton of coconut cream, by Alpro, as well as a creme fraiche by Oatly.


Similar to single cream.
Alternatively, you can put a tin of coconut milk in the fridge for two hours, whip it up, then add some vanilla and sweetener to taste. OR, I've found Co-yo Original makes a rather nice accompaniment for fruit.



10) Chocolate

As a woman you are practically duty bound to love chocolate! There's plenty out there, but it costs a bit more than the normal variety! I prefer Moo Free, which is also soya free and is sold by Waitrose and Sainsbury's (the larger stores, anyway). 

For a special treat I can definitely be persuaded to demolish a box of Booja Booja chocolates (Waitrose) or Cocoa Libre, check out their online store and stockists here! For more ideas, check out these posts.



11) Cake and biscuits

Oh yes, you can - indulge that is! There are cakes and biscuits in most Free From Supermarket aisles, although not so many in Tesco as in Sainsbury's I find! However, if you check some of the 'normal' packets, you can find some that are milk free! I used to love Respect Organics Carrot Cake (Tesco and Sainsbury's). The only reason I don't eat it anymore, is because I'm now gluten free too! 



I promise you, this tastes good!

These cup cakes, from Sainsbury's, I haven't tried, as they weren't around before I was gluten free, but they look good!


'Vanilla Fairies' by 'Emma's Country Cakes'

And if you've a little ones birthday coming up, check out the celebration cakes in the supermarkets, because quite a few are made without dairy. The Disney 'Frozen' cake available in Tesco and Sainsbury's, is just one of them!

As for biccies I used to love Hobnobs and my little one loves Waitrose Essential Chocolate Bourbons. Check out our 'Fave Products' page for more!



12) Cafes!

If, like me, you need your coffee, well this is an essential! However, you may want to go a little easy if you're breastfeeding! Just remember that the caffeine will go through you and keep your kiddo awake too! 

Most cafes stock soya milk and Starbucks now will serve coconut milk (for an extra 40p) - certainly the big chains, anyway, but be aware that if your baby is very sensitive to cow's milk protein you probably will have to give those lattes, cappuccinos and hot chocolates a miss - unless they have a machine dedicated to dairy free types, that is! Otherwise, however carefully they clean the spouts, traces of milk protein will most likely make their way into your coffee (see here for an explanation). I now stick with a black Americano (with a trace of sugar to take off the bitterness) but have seen people take in their own little bottle of milk!

In terms of snacks and nibbles in these places, Costa's mini gluten free cherry bakewells by the till and some of their wrapped gingerbread biscuits are made without dairy. Cafe Nero have coconut bars near the till, but don't expect anything like that in Starbucks - crisps, nuts and fruit bread without the butter are your lot there! We used to order out little one the sausage bap - it said it was dairy free, but some traces must have made their way through, possibly whilst being heated on the grill, so we don't take that risk anymore!


This bar is a bit crumbly but quite tasty!

If you can find a Coffee 1 near you, they sell a few dairy free cakes, although there's not much else on the menu that is dairy free, the other thing to be aware of is that they're not individually wrapped, so you run the risk of cross-contamination. I've also heard that Sainsbury's and Waitrose cafes will allow you to pick up free from products from their aisles and pay for and consume them in the cafe area, but there's none of those near me!


13) Eating out

So you're dairy free right now, but you still want to eat out, don't you? And, if you're careful, you still can! Of course you'll need to plan ahead a little bit before you go out. We usually start by checking out restaurants online - many chain restaurants can offer you something, although there's not so much choice as you may have been used to! 

In recent months, a website was launched called 'Can I eat there?' which works on the basis that members recommend places they've eaten that have been safe for them. This is a great idea, but you still need to check out a restaurant thoroughly, before you eat. I have found that restaurants can vary - even restaurants where you've previously been okay can still get things wrong. In my experience it's often down to the staff on the day. 

More information on eating out dairy free can be found on this page.


14) Baking & Cooking

A whole lot of stuff becomes daunting when you first go dairy free, one of which is cooking. Suddenly the rules appear to change. You need to check labels carefully and discover what dairy free substitutes will do for you. I well remember being gobsmacked by the fact that chicken gravy is often made with milk, that spaghetti bolognese is sometimes made with milk and that jam could be made with butter. Who knew?

You might find this post on dairy free baking quite helpful as well as this page which lists some of our favourite dairy free products.




When it comes to finding recipes, I've found that although you can buy expensive cookbooks or free from magazines (I've bought loads over time, which I hardly use), actually you can find a recipe for most things, just by looking online. This page lists a selection of other blogs which you may find useful.

If you're looking for dairy free cooking sauces, check out Tesco Free From section - they even now have a ready-made dairy free white sauce!


15) Celebrations

Christmas, Easter, Valentine's Day etc. means chocolate and all kinds of other goodies. There are dairy free alternatives and this page can help you find what you're looking for - so you don't have to miss out.



A few other little top tips for you:

1) Shopping

When I first went dairy free, food labelling was done a little bit differently, to how it is now. You will need to check every food label for 'milk' usually written in bold. You do still need to keep your wits about you, as one food manufacturer didn't think goat's cheese need to be labelled (as it wasn't cow's milk) and another listed yogurt, but didn't highlight that it was made with milk. 

Depending on how sensitive you/your little one is to milk and milk traces, you may also need to watch out for items that say they 'may contain' milk. This post explains why.

For tips on where to find your dairy free essentials (and luxuries) see here.


2) Medications

Medication can sometimes be made with dairy. Always remind your doctor/pharmacist and ask them to check anything that is prescribed/recommended for you/your little one.


3) Soaps & Lotions & Other Stuff!

Cleopatra famously bathed in milk and in modern times milk is still considered good for the skin. It's worth knowing that a LOT of soaps, shower gels, hand creams lotions, potions and even some washing-up liquids are made with milk! You may need to be aware of other words associated with milk, such as whey and casein, when you check through ingredients labels.

Just to warn you, although you may not be abstaining whilst breastfeeding, wine might also contain milk - believe it or not, it's used for clarifying the wine (as is egg, funnily enough). However, you may be pleased to hear that it's not always the case!


4) Probiotics

There's been a huge wealth of research recently into how allergies may be due to the kinds and lack of 'good' bacteria in our gut. It seems strange but true. Very recent research has shown that formula with this good bacteria added to it, has appeared to help overcome allergies in allergic babies (see here for article). 

If you're breastfeeding, your milk is packed full of probiotics anyway (see here), but scientists are still carrying out research into whether lactating mothers might be able to take probiotics to boost the probiotics in their milk and help their allergic little ones. You can't add just any probiotics Lactobacillus rhamnosus GG seems to be the most beneficial, but they've not yet reached the stage where it is regarded as a treatment.


5) If you slip up...

It's not unknown, slip-ups can happen. Somehow you eat/drink something with milk in. If this happens, and if your baby is quite sensitive, it will go through you and affect your baby. Don't beat yourself up about it, but there are some things you can do about it. 

It goes against the grain if you want to solely breastfeed, but it could be best for baby if you express your milk for a day or so, and formula feed instead. There are some dairy free formulas out there (see here), which you have to get on prescription. If you can get your doctor to get you an advance prescription, these will speed things up in the long run, as pharmacies don't tend to keep stocks of it and it can take a few days to order the formula in.


6) The mechanics

Any purely practical help, regarding the mechanics of breastfeeding, I would suggest getting in touch with La Leche League (their counsellors are excellent), or checking out Kelly Mom, a website from across the pond, with really great advice.




Well there it is, a whole load of stuff for you to consider! It's taken me some while to put all this info together - things I wish I'd known at the outset and some of which I've had to learn the hard way. And here's me still hoping I've included everything and still wondering what else I've missed! 

Hope you're not too overwhelmed by it all. It will get easier for you I promise!!

Be kind to yourself - the chocolate is pricier than normal, but actually...
I think you NEED, nay DESERVE it!  ;)


7) Finally...

Some advice from Carina Venter specialist pediatric allergy dietitian shared via Twitter:

  • No need to change diet during breastfeeding (except where allergen affecting child passes through breastmilk)
  • Aim to breastfeed for at least 4-6 months
  • Introduce food from 4 months, but don't delay beyond six months
  • If from a high risk family and breastfeeding is not possible or insufficient, use a partially hydrolysed  formula or extensively hydrolysed formula (as prescribed by a doctor).


Happy Breastfeeding!! 





Related posts: 

Monday, 10 September 2012

Can I interest you in a glass of broccoli?

Can I interest you in a glass of broccoli? Curly kale? Dried beans? No? Oh! That's a shame! These are some of the best sources of non-dairy calcium. Did you know that four and a half cups of broccoli are equal to the amount of calcium you'll find in a glass of milk? Now, I don't wish to alarm you, but that's quite a lot of broccoli isn't it? Now tell me how easy it is to get all your calcium from other sources, when you go dairy free!

Apparently, another source is beans. A lot of dairy free people tend to rely on soy beans for their dairy free substitutes. However, like many others who are dairy free, soy beans tend to have quite a nasty effect on me, so I don't think I'll be having those, thank you. And anyway, there's a problem with beans that I'll come to later.

I could have a glass of calcium enriched orange juice, but... I still can't cope very well with the orange stuff - following the tummy upset, that I caught the other year.

I don't know about you, but I keep coming across people, posts, sites that proclaim how easy it is to get your calcium from sources other than milk and how much better it is for you, anyway. 'Wow!' I've (nearly) thought, 'why did I ever drink milk at all? How did our mothers and grandmothers get it all so wrong?'

The thing is, I didn't think that. Partly because my Chinese mother-in-law now has to take calcium supplements on her doctor's orders, due to calcium deficiency, whilst my own mum has no problems, with her bones, whatsoever (my mother may have other health issues, but lack of calcium isn't one of them). I mention my mother-in-law's ethnicity, by the way, because the traditional Chinese diet often seems to be held up as the best example of a calcium-rich, milk free, diet. 

The other reason I don't agree that it is easy to get enough calcium from other sources is because I've been reading a range of articles, and, well... Can I just say lay my cards on the table right now, and just say that I'm downright sceptical about some of these claims? The way they're phrased, gives me an uncomfortable feeling that someone is trying to put across a particular agenda - the way they're worded they sound (to me) an awful lot like a publicity drive, rather than well-meant advice. 

I sometimes wonder if the people who write this stuff and make these kind of claims realise the impact they have on others. Look at it this way: 

I, as a busy mum, and one who is perhaps concerned about the lack of dairy in my child's diet (in terms of calcium) might be really excited seeing something like this. Not having the time to research the claims being made, or in fact have any clue that perhaps these claims might need to be investigated any further, might go my way in happy ignorance. And, what's more, might pass on those claims to someone else and be none the wiser that I was misleading someone else too. 

Now I'm not knocking those who think they've found something useful and pass it on, trying to be helpful, no I'm gunning for the people behind the original articles. 

Before you know it, everyone appears to be saying (and believing) the same thing, without knowing: 

1. Where it came from
2. Whether it is true              

I find this somewhat alarming! 

I don't know about you, but I want the truth! I want to be armed with the very best information, so that I can go out there and tackle this dairy free thing and not disappear off in what could be completely the wrong direction. It's for this reason, that I've been sticking with my very best friend - the calcium tablet (even though I have my concerns about that) whilst I try and work out exactly what the truth about calcium really is.


A short while ago, when I was researching my first post on calcium, I came across an article from a Canadian website. It was saying something that I was getting whispers of from other places - that a lot of the foods that everyone tells us are high in calcium (eg. spinach, soya) actually contain natural chemicals called 'phylates' and 'oxalates,' which can inhibit the body's ability to absorb calcium. In other words, oxalates are working against your best efforts!!        

Aaaagh! I can't tell you how much this frightened me!! So I sat on this information, (and kept taking my tablets) partly because I didn't want to frighten anyone else and partly because I was concerned that I might end up doing more harm than good! I was waiting for something else to come along and suggest a solution. And now I think I might have found one, or even some!

Food Preparation
Quite recently, I came across a website all about calcium, which was able to provide an answer about how to deal with the chemicals in food that block calcium absorption in the body. It's an old-fashioned technique that we probably all avoid these days, because juicing, wilting and steaming (steaming is usually my favourite option) is better for you. Right? 

Ah, no! Boiling is better, apparently, and chucking out the veggie water too - no using it for gravy now, y'all hear? If you want the full article, it can be found by following this link.  Mind you, you don't want to be overcooking the food, because that would take out other vital nutrients that your body needs.

Fermenting food is better, at reducing phylates, apparently, and fermenting soy (a natural source of calcium) is something that the South East Asians do very well - think miso and soy sauce.

Soaking and sprouting (beans, pulses etc.) are also ways of helping to overcome the problem.

However, I'm not sure that we should be 'chucking out the baby with the bath water' here - oxalate containing foods should not be seen as a 'problem'. One should not forget that the foods which contain oxalates also contain other nutrients (such as iron) that our bodies still need. There are other things that we can do to assist our bodies ability to absorb calcium.

Bio availabilty
It also helps to know which foods (that contain calcium) are best at allowing your body to extract the goodness that it needs. This is known as bio availability. I found a paper that detailed some of these foods and it turns out that broccoli** (one of my favourite veggies) is one of the best (hence my opening line)!

Maximize absorption
Another other string to the bow, is helping your body to absorb calcium more efficiently, by  ensuring you get sufficient Vitamin D, by eating leafy greens that contain Vitamin K* and by getting enough Vitamin A and magnesium - but not too much! Vitamin C is also apprently helpful. And guess what? All these vitamins and minerals are found in... broccoli!

Avoid calcium blockers
Finally, you need to avoid too many substances that inhibit your body from absorbing calcium -  such as caffeine, cola or chocolate (all contain oxalates) especially in meals that contain your doses of calcium (sigh). Bit of a shame that - I love my coffee, hot chocolate... and tea now you come to mention it! 

Phew! What a  lot to think about! 

Does it make you wonder how our ancestors ever coped - without modern nutritional advice! To be honest, I'm still not sure about some of it! You see researchers, including those who operate from top universities, are often sponsored by those who have a vested interest. Get my drift? 

So, I think I'll be sticking to trying to eat as balanced a diet as I can (bearing in mind certain intolerances that I have) and for now, at least, I'll be sticking to the calcium tablets (with Vitamin D) that I was recommended to take in the first place! 

Oh! And I'll keep eating broccoli!

How about you?

P.S. If you want a rough idea about the quantity of calcium you consume, Calcium Calculators like this (Canadian) one may give you some idea.

Please note: I am not an 'expert' on nutrition and am unable to vouch for the links that I have supplied. For proper medical advice, please consult a properly qualified dietitian.

*If you're taking Warfarin you will probably already be aware that it is advisable to be careful about Vitamin K.

**Unfortunately, broccoli can apparently be unhelpful for those with thyroid problems.


Related Posts:


Friday, 20 April 2012

Getting enough? Vitamin D for you and me.

Funny how an idea can be swimming around in your mind then, POW! All of a sudden, it's headline news. Apparently, ignorance of the importance of Vitamin D can kill. Wow! I'd been planning to write about it, but I didn't know that! And, just in case you wonder, I'm not being flippant - because for poor little Jayden, although his case is unusual, that's the shocking truth. If his parents had known, about the 'Sunshine Vitamin' as it's sometimes called; if the doctors treating the poor little baby had recognised the signs of its absence, this little baby would still be alive today. What a tragic and completely preventable outcome!

Yet, it could happen to anyone of us! Apparently, according to the BBC (assuming they  got their facts right) 74% of parents and more than half of Healthcare professionals in the UK are also ignorant of the facts! That I find completely shocking (especially as the Daily Mail seems to churn out articles about Vitamin D with a fair amount of regularity)! The parents - perhaps not so shocking (as when I think about it - I didn't know, until the dietitian warned me to give Baby Vitamin D drops) but surely you would expect the Healthcare professionals to know and be doing something about it! Wouldn't you?

In fact, it seems that due to dietary measures (like taking Cod liver Oil) that were taken when Rickets was a common occurrence, the disease appeared to have died out and was relegated to the pages of history. It was considered by many as a Victorian disease. Doctors in practice now, may never have come across a case and so therefore may not actually recognise it, when they see it. 

Unfortunately, it appears that during the 1950's concern developed over whether people might be having too much Vitamin D and, in the UK, dietary supplements were stopped. This seems to have contributed to a modern rise in the number of cases. Add to this, concerns about over exposure to UV rays, which have led many to avoid contact with the sun - a natural source of Vitamin D.


Why is it so important?

The fact is, whatever age we are, we all need Vitamin D. Among other things, it helps to regulate the amount of calcium (remember that, from my previous post) and phosphate in the body which, in turn, means healthy bones and teeth. 

It also helps your body's immune system - one of the reasons why there may be a connection between children with food allergies and Vitamin D deficiency. It is also thought that Vitamin D may play significant role to play in preventing cancer, cardiovascular disease, and multiple sclerosis, although further research is needed to prove these links.

What is recognised, is that lack of Vitamin D, causes problems with bones. In older people it can lead to Osteomalacia. Sadly, in Jayden's case, it led to a severe case of rickets. 


Who needs it?

Recently Public Health England updated their advice on Vitamin D (Updated July 2016). They now recommend that all adults take a daily Vitamin D supplement, especially during Autumn and Winter, when it is not possible to get our daily Vitamin D allowance from the sun. However, there are some groups more at risk, than others, from Vitamin D deficiency. These include:
  • pregnant women
  • breastfeeding women
  • babies and young children (under five years old)
  • older people (over 65)
  • people whose skin is not exposed to the sun e.g. because it is covered up by clothing or because they are housebound
  • darker skinned people

So how much of the 'Sunshine Vitamin' does one need?

Well this, like calcium, depends on where you live! 

In the UK, The Department of Health recommends the following:
  • pregnant & breastfeeding women - 10 Âµg (microgrammes) or 400 iu/international units (daily
  • babies & young children (6 months to 5 years)* - 7.0-8.5 Âµg daily (in the form of drops)
  • older people, the housebound, dark skinned etc. - 10 Âµg daily
*However, formula fed babies do not require drops, unless they are fed less than 500ml formula a day - as formula is especially fortified with the correct amount of Vitamin D. Breastfed babies (there's little Vitamin D in breast milk) may need, however, to be given Vitamin D drops from the age of one month, unless the mother has been taking supplements during pregnancy!

In the US, the FNB recommends slightly higher doses of Vitamin D:

  • 0-12 months 10 Âµg daily
  • 1-70 years    15 Âµg daily
  • 70+ years      20 Âµg daily

These amounts are based on the supposition that those concerned are getting minimal sun exposure.


Where can I get it?

Sadly not in chocolate! I know!! Believe me, I have looked! However a study is currently being conducted into how three squares of dark chocolate a day could help prevent skin damage from the sun - which is important if your'e planning on getting your Vitamin D RDA from sunlight!

Sunlight
Vitamin D is not called the 'Sunshine Vitamin' without reason! Interestingly enough, it seems that you cannot overdose on Vitamin D absorbed in this way, however, you can get skin burned and that, of course, can be harmful. 

Some research has indicated that between 5 -30 minutes of sun between 10am and 3 pm (without sunscreen) at least twice a week provided a sufficient amount of sun exposure. That was with face, arms, legs or back exposed. 

Some exposure to the sun can be helpful, but be careful!
In an interview I heard on the radio, the other year, a more conservative amount was suggested. 10 minutes (without sun screen) of exposing arms and legs to the sun, when the temperature was over 25 degrees Celsius, was considered sufficient. As I remember it, I believe the advice was to avoid the midday sun, but to get late afternoon sun, where possible. Of course, living in the UK, that can prove tricky!

Last summer, with that in mind, I got Baby out and about as often as possible and held back slapping sun screen on Baby, until she had been out in the sun for at least 10 minutes. The dietitian seemed happy with that (as I had also been concentrating on getting Vitamin D into her diet) but as baby had proved to have a reaction to her Vitamin D drops, was still keen for me to start giving Baby Junior Soya milk (with added Vitamin D) so that Baby's intake could be more easily calculated and assessed.

However, because of the risks of skin cancer, most Health Professionals advising on Vitamin D prefer that people look to diet or supplements for their RDA instead of relying on sunlight.

Diet
There are (limited) ways of ensuring that you get your Vitamin D RDA through your diet. Should you be thinking of trying to do so, the following (extracted from the US Office of Dietary Supplements NIH) could prove useful:

Table 3: Selected Food Sources of Vitamin D [11]
FoodIUs per serving*Percent DV**
Cod liver oil, 1 tablespoon1,360340
Swordfish, cooked, 3 ounces566142
Salmon (sockeye), cooked, 3 ounces447112
Tuna fish, canned in water, drained, 3 ounces15439
Orange juice fortified with vitamin D, 1 cup (check product labels, as amount of added vitamin D varies)13734
Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup115-12429-31
Yogurt, fortified with 20% of the DV for vitamin D, 6 ounces (more heavily fortified yogurts provide more of the DV)8020
Margarine, fortified, 1 tablespoon6015
Sardines, canned in oil, drained, 2 sardines4612
Liver, beef, cooked, 3 ounces4211
Egg, 1 large (vitamin D is found in yolk)4110
Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 0.75-1 cup (more heavily fortified cereals might provide more of the DV)4010
Cheese, Swiss, 1 ounce62

* IUs = International Units. 40 IU is the equivalent of 1 Âµg (microgramme)
** DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration to help consumers compare the nutrient contents among products within the context of a total daily diet. The DV for vitamin D is currently set at 400 IU for adults and children age 4 and older.
Please note: milk in the US is fortified with Vitamin D. This is not so, in the UK. However, if you're dairy free and are using a milk substitute, then it probably is fortified with Vitamin D (as well as Calcium). Just check the carton, to make sure!

Dietary Supplements
In the UK, Vitamin D supplements can be obtained fairly easily - they can be bought over the counter at pharmacies and supermarkets. Additionally, women and children who are under 'Healthy Start' can get free Vitamin D supplements. Pregnant women, however, should avoid Vitamin supplements that also contain Vitamin A.

Is there a 'right' kind of Vitamin D supplement?
It's difficult to get a definitive answer on this one, although people often seem to prefer D3 over D2. A recent study would seem to indicate D3 is perhaps better, but personally, I think it indicates that D2 is also fine.


How much is too much?

Believe it or not, it is possible to have too much Vitamin D! As with anything, it's all about moderation. Taking too much Vitamin D over a long period can cause the body to absorb too much calcium, which can lead to kidney problems. It's a particular problem for people with hyperparathyroidism, who are more sensitive to Vitamin D and also for pregnant women too as too much can cause some foetal abnormalities. 

However, there should be no need to panic about such things if you are taking normal Vitamin D supplements. For example, my daily calcium supplement, which also contains my daily dose of Vitamin D,   provides - 10mcg (100% of my RDA - UK). The NHS Choices website, maintains that doses of 25mcg or less is 'unlikely to cause harm'. 

In fact, the levels considered suitable by the NHS (UK) are way below the Upper Intake Levels as set out by the National Academies Press (US): 

  • 0-6 months   25 Âµg/1 000 IU
  • 6-12 months 38 Âµg/1 500 IU
  • 1-3 years      63 Âµg/2 500 IU
  • 4-8 years      75 Âµg/3 000 IU
  • 9-71+ years  100µg/4 000 IU                  (IU = International Unit)

So that's all right then, for us! 

Now let's pass the message on...