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Vitamin Deficiency in pregnancy.

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I am a lacto vegetarian and am currently exclusively breastfeeding my 14 week old son. My baby recently had some symptoms of a possible food allergy and his pediatrician suggested that I eliminate dairy from my diet. Since dairy is the only animal product I consume, I am concerned about getting enough Vitamin B12, Zinc, Vitamin D and Calcium for my baby. I am currently taking a daily Prenatal Vitamin (Prenate Mini) which contains Vitamin B12 (cyanocobalamin): 13 mcg, Calcium (calcium carbonate): 100 mg and Vitamin D3 (cholecalciferol): 220 IU.

Would it be ok for me to also take a B12 Vitamin supplement, Zinc and Vitamin D/Calcium supplement in addition to my prenatal vitamin while I am not consuming dairy in order to ensure adequate nutrients? I also don´t want to take in too much of these nutrients if that could be detrimental to our health. Is there a limit to how much of the nutrients the supplements should contain? I should mention that my baby is not on Vitamin D supplements, since his pediatrician does not believe they are necessary.

Thank you.


Category: Family Physician-GP

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello,

Thank you for choosing DoctorSpring.

Being a Vegetarian who is not consuming Dairy products puts you and your baby in a higher risk side for nutritional deficiency of Vitamins. You will need to take supplement. TThe Recommended Intakes (RI) for nutrients have a wide safety margin built in.

I will break it down for you here :

1.Energy — The energy cost of exclusive breastfeeding from birth through six months postpartum is 500 kcal/day. You can easily make it up by eating calorie rich food items like potatoes, sweet potatoes etc.

2.Protein — The additional protein requirement for the first six months of lactation is 25 g per day. Since you are not taking milk YOU WILL need make up for this by consuming protein rich food items such as Pulses.

3.Fat-soluble vitamins - Vitamin A does not need supplementation usually. But in certain population it is considered essential.

Vitamin D - make you and your baby get some sun exposure. You are taking 100mg Calcium + 220 IU Vitamin D which is anyway inadequate. You will need to take at least 500mg Calcium.

4.Vitamin B12: you are already getting sufficient B12 in your supplement. (around 10mcg will do) In addition you can have fortified soya and fortified cereals which are rich in B12.

5. Other Water soluble Vitamine - B1 , Folate. You will need to supplement these as per the recommended daily allowance recommendations.

6.Zinc: You do not require to take additional supplements. You can consume plant sources like beans, nuts, whole grains, fortified cereals. Availability of zinc from plant foods is lower than from animal foods, but plant foods are still a good source and is sufficient for you.

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My recommendations would be :

1) Continue Prenate Mini - It will take care of Vitamin B6, B12, Folic Acid, Vitamin C, Biotin, Iron, Iodine, Vitamin D.
2) Take additional Calcium of 500mg per day (It is for you, not your baby)
3) Take care of Protein, Energy needs.
4) If you baby is Sun exposed (indirect exposure would do) Vitamin D supplementation is not needed. However do talk to your Paediatrician about VItamin A and D supplement for your baby. In certain population groups it is done. Since your Doctor will be the best person to decide on this based on local recommendations. Personally I would actually recommend one or two doses of Vitamin A supplementation.
5 ) Re Evaluate whether you really need to avoid milk altogether (This is important)
6) Fortified breakfast cereals, Soya milk , other nutrient rich food items to be included into your diet.


Hope this helps
Feel free to ask followups
Thank you


Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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