new vitamin D guidelines for kids

by Diane Lofshult

Food for Thought:

The American Academy of Pediatrics (AAP) recently released updated guidelines that double the daily dose of vitamin D for children previously recommended in 2003. Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents recommends that all children receive 400 international units (IU) of vitamin D each day, starting in the first 2 months of a child’s life.

The change from the 2003 dosage recommendation of 200 IU/day of vitamin D for children was prompted by new research on rickets, a bone-softening disease that can be prevented with adequate daily vitamin D intake. Unfortunately, it is difficult to get enough vitamin D through diet alone. Although sunlight is an excellent source of vitamin D, most children are not outside often enough or wear sunscreen, which limits exposure to the vitamin.

Breast-fed infants are particularly vulnerable to rickets unless they receive vitamin D supplementation. That’s why the AAP recommends that exclusively and partially breast-fed infants get a daily supplement that contains 400 IU of vitamin D beginning in the first few days of life.

“Breast-feeding is the best source of nutrition for infants,” according to Carol Wagner, MD, FAAP, co-author of the revised guidelines, who was quoted in an AAP press release announcing the new report. “However, because of vitamin D deficiencies in the maternal diet, which affect the vitamin D in a mother’s milk, it is important that breast-fed infants receive supplements of vitamin D.”

The guidelines also recommend supplements for non-breast-fed infants and older children who consume less than 1 quart of fortified milk or formula per day. Adolescents who do not get enough vitamin D through food alone are also advised to take a daily supplement with 400 IU. Children who take certain medications may be at risk of vitamin D deficiency, so check with your pediatrician for advice on possible supplementation needs.

The Institute of Medicine, a government advisory panel that sets federal dietary standards, is currently reviewing the revised AAP vitamin D recommendations for children. The full AAP report was published in the November issue of the academy’s Pediatrics journal.

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