New Guidelines – Children Need Twice as Much Daily Vitamin D
The American Academy of Pediatrics has recently revised recommendations for Vitamin D based in new information indicating that children need twice as much Vitamin D as originally thought.
In the new clinical report, “Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents,” published in the November issue of Pediatrics, it is recommended that all children receive 400 IU a day of vitamin D, beginning in the first few days of life. The previous recommendation, issued in 2003, called for 200 IU per day beginning in the first two months of life.
The New Recommendations include:
- Breastfed and partially breastfed infants should be supplemented with 400 IU a day of vitamin D beginning in the first few days of life.
- All non-breastfed infants, as well as older children, who are consuming less than one quart per day of vitamin D-fortified formula or milk, should receive a vitamin D supplement of 400 IU a day.
- Adolescents who do not obtain 400 IU of vitamin D per day through foods should receive a supplement containing that amount.
- Children with increased risk of vitamin D deficiency, such as those taking certain medications, may need higher doses of vitamin D.
Preventing Rickets and Osteomalacia
Sufficient amounts of Vitamin D helps prevent rickets in children and osteomalacia in adults.
In children, vitamin D deficiency causes rickets, a disease characterized by a failure of bone tissue to properly mineralize, resulting in soft bones and skeletal deformities. Rickets continues to be reported in the United States in infants and adolescents. The greatest risk for rickets is in exclusively breastfed infants, particularly among African American infants, who are not supplemented with 400 IU of vitamin D a day.
In adults, vitamin D deficiency can lead to osteomalacia, resulting in weak muscles and bones.
Vitamin D from the Sun
For many people, eating vitamin D-fortified foods and being exposed to sunlight are needed to maintaining a healthy vitamin D status.
Given enough sun exposure the body is able to make Vitamin D. However, the AAP advises keeping infants out of direct sunlight and having them wear protective clothing and sunscreen to protect against skin cancer.
This extensive use of sunscreens and placement of children in daycare programs, where they often have less outdoor activity and sun exposure has also contributed to less Vitamin D.
The general recommendations for sun exposure are three 15 minute intervals a week. It is difficult to determine a safe amount of sunlight exposure to synthesize vitamin D in a given individual.
Good Food Sources for Vitamin D
Very few foods in nature contain vitamin D. The fish (such as salmon, tuna, and mackerel) and fish liver oils are among the best sources. Small amounts of vitamin D are found in beef liver, cheese, and egg yolks. Vitamin D is also being added to Orange Juice.
- Vitamin D Fortified Milk – Four cups daily to meet the requirement.
- Cereals (fortified)
- Oily fish – tuna, mackerel and sardines
- Beef Liver
- Cheese
- Egg Yolks
Sources:
American Medical Association. October 14, 2008. New guidelines suggest children should get twice the daily dosage of vitamin D previously recommended. AMA Morning Rounds.
American Academy of Pediatrics. Vitamin D Deficiency Clinical Report. Patient FAQs.
American Academy of Pediatrics. October 13, 2008. New Guidelines Double the Amount of Recommended Vitamin D.
Office of Dietary Supplements. Dietary Supplement Fact Sheet: Vitamin D. National Institutes of Health.
Milk, Sunshine Each Day Keep the Doctor Away. Washington Post.
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