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Why Every Pregnant Woman Should be Concerned About Her Vitamin D Level

Posted on January 23rd, 2013 by | 0 views

Low levels of vitamin D during pregnancy can have devastating effects on the health of the mother and baby, and research is now identifying a unique occurrence which happens only in pregnancy and at no other time in the lifecycle.  These are just two reasons why Natural Baby Pros supports vitamin D screening and the GrassrootsHealth ‘Protect Our Children NOW!’ program, which are essential to improving health outcomes for pregnancy and babies.

What’s the Big Deal About Vitamin D?

Vitamin D, the sunshine vitamin, is a hot topic these days with claims of its health effects ranging from proper growth and development in children to anti-aging and cancer fighting properties and improved mortality rates in adults.  Over the past several decades, scientists from around the world have continued to uncover the many roles of vitamin D within the body, and debate has sparked over the current recommendations of vitamin D intake and serum levels needed for optimal health.  Studies have shown such results as a 50% reduction in influenza rates in children, an 80% reduced risk of type 1 diabetes, an 83% reduction in breast cancer risk, and a 50% reduction in preterm labor and other complications in pregnancy, all due to higher intakes and higher resulting serum levels of vitamin D, compared to what is currently recommended by the Institute of Medicine (IOM) and, subsequently, most physicians.  

Because of this, there remains confusion around vitamin D, especially regarding the recommended daily intake and what serum levels of vitamin D are safe and necessary for disease prevention, proper growth, and wellness.  While many studies have concluded that the current recommendation of 600 IU per day is grossly inadequate for overall health, other studies are now emerging that clearly define certain processes within the body that require a much higher intake dose and serum level of vitamin D in order to operate efficiently.

Vitamin D and Pregnancy

Pregnancy presents an exceptional and exaggerated example of the above.  There is something very unique concerning the metabolism of vitamin D that occurs only during pregnancy and at no other time in the human lifecycle.  While the conversion of vitamin D is normally directly related to serum calcium levels, during pregnancy there is an uncoupling of vitamin D metabolism from calcium.  If a pregnant woman has adequate levels (40-60 ng/ml) of 25(OH) vitamin D, the precursor to active vitamin D, her body will convert twice the normal amount of active 1,25(OH) vitamin D by the end of the first trimester, and over three times the normal amount by birth, with her calcium levels remaining normal.  This could potentially indicate a physiological need for greater availability of vitamin D during pregnancy than at any other time in human life, and for reasons other than bone and calcium homeostasis.

Dr. Carol Wagner is a pediatrician, neonatologist, and leading researcher in vitamin D, pregnancy, and the‘Protect Our Children NOW!’ program study.  Her current findings demonstrate that the serum level of 25(OH) vitamin D required to optimize active 1,25(OH) vitamin D production is 40 ng/mL (100 nmol/L).  In other words, in order to normalize vitamin D metabolism during pregnancy, a woman must have a 25(OH)D serum level of at least 40 ng/mL.  Unfortunately, studies have shown that over 80% of pregnant women, even in sun-exposed climates and those taking prenatal supplements, are well below this level, and are therefore not converting the physiological amount of vitamin D that could be needed for her health and her developing fetus.  Additionally, in a study focused on the safety and effectiveness of supplementing to correct vitamin D deficiency in pregnancy, Dr. Wagner and others were able to show that a daily dose of 4000 IU of vitamin D3 per day, starting at 12-16 weeks gestation, was not only safe for both the mother and baby (no adverse effects were seen throughout the study), but was also effective in raising the mother’s 25(OH) D serum levels and providing sufficient levels to her baby at birth.  The study also noted that the current recommended intake of 400 - 600 IU per day was ineffective at raising the mother’s serum levels, and that each baby born to the mothers who were taking this low dose were born deficient.

In more recent studies, Dr. Wagner and others have also noticed a clear association between lower risk of co-morbidities in pregnancy and higher maternal levels of 25(OH) vitamin D, including preeclampsia, gestational diabetes, preterm birth, prenatal infections, and risk of cesarean section.  Even the March of Dimes, a well-known and respected organization focused on combating the rising rates of preterm birth, is now looking into the effects of vitamin D on pregnancy and is finding strong evidence in their preliminary studies.  These findings, along with a wealth of others showing the extensive health effects of vitamin D beyond bone and calcium metabolism, and pointing to potential long-latency adult effects of vitamin D during pregnancy and childhood, have sparked the need for immediate mass action concerning vitamin D and pregnancy.  “Many long-term adult diseases are potentially affected by vitamin D levels during childhood and pregnancy, which increases the urgency to monitor and correct vitamin D serum levels, especially in pregnant women, babies and children,” says Dr. Wagner. 

Vitamin D Deficiency: A Lifelong Sentence for Our Children?

Vitamin D deficiency in children is a growing concern among pediatricians world-wide.  In 2008, theAmerican Academy of Pediatrics increased their recommendation of vitamin D supplementation from 200 IU/day to 400 IU/day for all infants, stating that “supplementation with Vitamin D, starting soon after birth, is recommended because breastfed infants generally do not obtain adequate Vitamin D from other sources.”  However, fewer than one quarter of all infants, and only 5-13% of breastfed infants met these recommendations for vitamin D.  In February of 2012, physicians at John Hopkins Children’s Center released a notice to all pediatricians to “Screen All Kids for Vitamin D Deficiency.”  In it they acknowledge that “prolonged and untreated vitamin D deficiency can affect multiple organs and functions,” especially in growing and developing children. 

Even rickets, a disease related to extremely low levels of vitamin D, once thought to have been wiped out long ago with vitamin D fortification and daily recommendations, is now being identified in more children.  Sadly, it is being misdiagnosed as child abuse, causing innocent families to lose their children.  Dr. Michael Holick, MD, PhD, a well-known expert in the vitamin D field, speaks of rickets as just the “tip of the vitamin D iceberg.”  What is now being uncovered is the immune function “priming” occurring during infancy and childhood, and the lifelong impact of this deficiency on that developing child.

The issue that is frequently missed when considering the vitamin D deficiency epidemic is the underlying reason that these babies, and their mothers’ breast milk, are lacking vitamin D in the first place.  A mother who is deficient in vitamin D cannot provide adequate levels to her baby during pregnancy and especially when breastfeeding. As Dr. Wagner quotes “If a woman is vitamin D deficient during her pregnancy then her fetus has no chance of having vitamin D sufficiency.”  Unfortunately, the majority of women are not getting the vitamin D education, screening, and supplementation they need at the time they need it most – during pregnancy when a baby’s growth, development, and future health are most influenced and vulnerable.  Even more reason vitamin D deficiency should be addressed well before a baby is born. 

A separate study of Dr. Carol Wagner’s looked at vitamin D in lactating women and their babies, and discovered that a lactating mother needs 6,400 IU/day of vitamin D from sunshine or supplements in order to provide adequate amounts of vitamin D to her baby.  Unfortunately, most women these days avoid the sun, overuse sunscreen, and take prenatal and multi vitamins containing only 400-800 IU/day of vitamin D – a far stretch from what is truly needed! 

The Urgent Need for Action

With the rise of health issues such as autism, allergies, obesity, and other immune deficiencies as well as more obvious links between vitamin D deficiency and maternal and fetal immune function, it seems that the sense of urgency is growing in order to support the health and wellbeing of future generations. GrassrootsHealth’s ‘Protect Our Children NOW!’ program is just one way to affect such change.  As Dr. Carol Wagner has stated, "The involvement of over 1000 women who have chosen to participate in this population based study will provide unprecedented data and information that will unequivocally show the importance of vitamin D during pregnancy and will be the motivating factor in defining and re-defining public policy and strategies to improve health during pregnancy.  It is essential that we have this kind of participation because it will move the focus from what could potentially take decades into a timeline that is compacted within 5 years."

GrassrootsHealth, a non-profit 501c3 public health promotion and research organization, and leader of the world’s largest vitamin D outreach project, D*action, is stepping up to take action on behalf of all pregnant women and their babies with their ‘Protect Our Children NOW!’ program.  “When a solution to as much as one half of the pain and anxiety of a troubled pregnancy is demonstrably safe and easy to obtain, it’s urgent to pull together all the resources we need to get action right now, without delay” says Carole Baggerly, director of GrassrootsHealth.  The program, which will start in San Diego, aims to fully explore the health impacts of achieving and maintaining vitamin D serum levels of 40-60 ng/mL during pregnancy.  All participants will have their vitamin D serum levels measured, and health outcomes will be tracked and carefully measured.  Full scientific reports will be published for the community's awareness.  “We are starting at the community level to fully affect world-wide change, and in doing so, we must very thoroughly measure, document and publicize the findings so everyone can see what needs to be done,” says Baggerly.  “We could potentially eliminate 2500 cases of pregnancy complications or more per year for San Diego moms alone. With the help of local community groups, participants, and volunteers, we have the power to move current research findings forward quickly into a much healthier practice.”

How Can You Participate?

GrassrootsHealth is now gathering signature endorsements and financial sponsorships for the ‘Protect Our Children NOW!’ program.  “Say you care” to see this program succeed by endorsing the program goals and adding your name to the list of supporters, which includes Dr. Bob Sears, author Jan Roberts, theCanadian Childbirth Association, and many other individuals, practitioners, and groups; view the endorsement letter and sign the form here.  To get involved in the D*action Program to ‘Protect Our Children NOW,’ as a sponsor, advocate, volunteer, or to host a fundraising event, please contact Jen Aliano, Communications Director for GrassrootsHealth.   

GrassrootsHealth is a 501c3 non-profit organization whose total mission is to solve the vitamin D deficiency epidemic.  More information about GrassrootsHealth can be found athttp://www.grassrootshealth.net and the ‘Protect Our Children NOW!’ program at http://www.daction.org/poc.

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