Very high vitamin D supplementation rates among infants aged 2 months in Vancouver and Richmond, British Columbia, Canada

Mothers of all healthy infants born between April and May 2010 were approached to participate. Telephone surveys were conducted with 577 mothers (response rate 56%) when their infants turned 2 months.Over half of the infants received only breast milk in the week prior to the survey. One third received a mixture of breast milk and infant formula and 10% received only formula. About 80% of the infants were supplemented with vitamin D at 2 months. Infants who received only breast milk were most likely to be supplemented with vitamin D (91%). Over 60% of the infants had a total vitamin D intake of 300- < 500 IU/d from supplements and formula and only 5% did not receive any vitamin D. Most parents were advised to give vitamin D supplement by health professionals, such as public health nurses, midwives, and doctors.About 90% of the infants received breast milk at 2 months of age. The vitamin D supplementation rate was 80%. Future studies are needed to monitor breastfeeding duration and vitamin D supplementation rates as infants get older.Worldwide public health authorities recommend exclusive breastfeeding for the first 6 months of life for healthy term infants [1-3]. Breast milk is the best food for optimal growth of the infant and breastfeeding has been associated with improved health outcomes for mother and infant [1]. While breast milk is the ideal food for infant, it does not generally supply adequate amounts of vitamin D [4]. As such, breastfed infants are at risk of vitamin D deficiency [5]. In its most serious form vitamin D deficiency in infancy leads to rickets, a condition characterized by weakened bones, resulting from poor mineralization of newly formed bone tissue [6]. Additionally, there is emerging evidence that lack of vitamin D during infancy, is associated with altered calcium metabolism [7], early childhood tooth decay [8], and increased risk of Type 1 Diabetes [9], and asthma later on [10].While infant formula is fortified with vitamin D, breastfed in