A nurse is promoting exclusive breastfeeding for the first six months of life and continued breastfeeding for up to two years or beyond.

Which of the following benefits of breastfeeding should the nurse include in her education?

Breast milk does not contain enough vitamin D for bone health.Vitamin D is needed to support healthy bone development and to prevent rickets, a condition that causes weak or deformed bones.Breast milk alone does not provide infants with an adequate amount of vitamin D.The Dietary Guidelines for Americans and American Academy of Pediatrics recommend breastfed and partially breastfed infants be supplemented with 400 IU per day of vitamin D beginning in the first few days of life.

Choice B is wrong because breast milk does not interfere with vitamin D absorption from sunlight.However, reducing sun exposure is important for preventing skin cancer, and other factors such as clothing, air pollution, and skin type can also decrease the amount of vitamin D a person can make from sunlight.

Choice C is wrong because breast milk does not increase vitamin D excretion in urine.

Vitamin D is a fat-soluble vitamin that is stored in the body and not easily lost in urine.

Choice D is wrong because breast milk does not inhibit vitamin D synthesis in the liver.Vitamin D is synthesized in the skin from exposure to sunlight, and then activated in the liver and kidneys to its active form.

Breast milk does not affect this process.

“I will give my baby soft finger foods that he can pick up and eat by himself.” This statement indicates an understanding of the teaching because it shows that the mother knows how to provide appropriate complementary foods for her infant who is eight months old.Complementary feeding, also known as weaning, mixed feeding or introduction of solid foods, should begin for infants by six months of age (26 weeks) but not before 17 weeks.Breast milk or infant formula should continue during the complementary feeding period with amounts gradually reduced as the variety of foods increases.WHO and UNICEF recommend that infants start receiving complementary foods at 6 months of age in addition to breast milk.Initially, they should receive complementary foods 2–3 times a day between 6–8 months and increase to 3–4 times daily between 9–11 months and 12–24 months of age.Complementary foods should be nutritionally adequate, safe, and properly fed.

Choice A is wrong because pureed foods are not suitable for an eight-month-old infant who can handle more textured foods.

Pureed foods are recommended for infants who are just starting complementary feeding at around six