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Monday, October 13, 2008

New Vitamin D Recommendations for Infants and Children:

In November, The American Academy of Pediatrics, AAP, will be releasing revised guidelines for vitamin D intake for infants and children. The new guidelines differ from the old in two major ways: 1. the amount of vitamin D that should be supplemented to infants and children and 2. when supplementation should start.

The new guidelines recommend that all infants, children and adolescents have a daily intake of 400 IU of vitamin D, which is an increase from the previous guideline of 200 IU daily. This new recommendation was implemented based research indicating that a growing number of children are vitamin D deficient and that the incidence of vitamin D deficiency rickets is rising. (For more information about rickets visit

Vitamin D is a fat-soluble vitamin that has many health benefits, most notably its role in strong healthy bones. A deficiency in vitamin D can lead to many health problems in children, including vitamin D deficient rickets. The body makes Vitamin D naturally when the skin is exposed to sunlight. With Americans limiting sun exposure and with children drinking less vitamin D fortified milk, children and adults are not getting as much vitamin D as they used to from these sources. One would have to drink 32 oz of milk a day in order to obtain 400 IU of vitamin D from milk. However, we, as pediatricians, advise parents not to give children more than 16 -24 oz of milk a day, as the calcium in the milk can inhibit the absorption of iron, leading to iron deficient anemia. Supplementation through vitamins is, therefore, necessary to obtain adequate daily intake. Tri-Vi-Sol and Poly-Vi-Sol, or their generic equivalents, have 400 IU per 1mL dropper or one chewable tablet. (Tri-Vi-Flor and Poly-Vi-Flor contain the same vitamins as their Vi-Sol counterparts with the addition of fluoride).

The second major change addressed in the new recommendation is when to start supplementing vitamin D to breastfed infants. The new guidelines state that breastfed and partially breastfed infants should start supplementation within the first few days of life. Previously, it had been believed that infants did not need to start supplementation until 2 months of age. This new recommendation is based on research indicating that many mothers are also vitamin D deficient and subsequently are producing breast milk with less vitamin D. Since infant formulas are vitamin D fortified, infants receiving 32 oz or more of formula a day need no additional supplementation.

Parents should check their children's multivitamin to determine the amount of vitamin D it provides per serving. Remember, if the tablet has 400 IU per tablet but the child only takes half a tablet a day, then he is only receiving 200 IU. However, this may be sufficient if he is also drinking 16 oz of milk daily. Parents should discuss these new recommendations with their children's pediatrician.

For more information on vitamin D, it's health benefits and it's sources, visit the National Institute of Health's website,, but please note that they have not yet changed their "Adequate Intake" table to reflect the new, 400 IU, recommendation.