EnglishAbout the AAPAAP Press Room > About the AAP > AAP Press Room > Vitamin D Supplementation for Infants Vitamin D Supplementation for Infants Breastfeeding is the ideal form of infant feeding, but supplementation with Vitamin D, starting soon after birth, is recommended because breastfed infants generally do not obtain adequate Vitamin D from other The study, “Adherence to Vitamin D Recommendations Among U.S. Infants,” published in the April issue of Pediatrics (released online March 22), examined data from the Infant Feeding Practices Study II conducted from 2005 to 2007. Approximately half of the infants who were breastfed, formula-fed, or mixed fed met the 2003 American Academy of Pediatrics (AAP) recommendation of 200 IU of vitamin D per day, but fewer than one-quarter would have met the current, 2008 AAP recommendation of 400 IU per day. While formula-fed infants receive Vitamin D supplementation from the formula, study authors found that the
amount consumed may not be adequate to meet the 2008 AAP Pediatricians should encourage parents of infants who are either breastfed or consuming less than 1 liter (just under 1 quart, or 33.8 ounces) of infant formula per day to give their infants an oral Vitamin D supplement to meet the current AAP recommendation. The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. If you think your child is getting enough vitamin D by just drinking milk, you're probably wrong. Recent studies show that most children aren't getting enough of this essential vitamin.In October 2014, the American Academy of Pediatrics (AAP) responded by increasing the amount of vitamin D it recommends for children and adolescents. According the AAP clinical report,
Optimizing Bone Health in Children and Adolescents, infants under 12 months require 400 International Units (IU) per day and older children and adolescents require 600 IU per day. Common wisdom says that if you're child drinks milk and plays outside, he's getting enough vitamin D, right? We know more about vitamin D than we did even five years ago. Because of lifestyle changes and sunscreen usage, the majority of the population shows signs of vitamin D deficiency. Vitamin D helps ensure the body absorbs and retains calcium and phosphorus, both critical for building bone. A vitamin D deficiency can lead to rickets, a bone-softening disease that continues to be reported in the United States mostly in children in the first two years of life. Vitamin D Deficiency and Rickets for more information. Vitamin D deficiency also increases the risk of bone fractures in older children, teens, and adults. The increase in the recommended amount of vitamin D children need each day is a result of new evidence showing its life-long health benefits.
Supplementation is important, because most children will not get enough vitamin D through diet alone.It is important that breastfed infants receive an adequate supply of vitamin D through a supplement of 400 IU per day. For formula-fed babies, the requirements are the same. Unless the child is drinking 32 ounces of infant formula per day, a vitamin D supplement is required. If a child or a teenager is not consuming enough vitamin D in his or her diet, a supplement may be needed.When it comes to giving your child a vitamin D supplement, there's nothing new about the process. Any chewable multivitamin supplement for kids that contains 400 IU of vitamin D is acceptable. There are several liquid vitamin preparations for infants that contain 400 IU vitamin D per dose, as well. Chewable vitamins are generally regarded as safe for children over the age of three who are able to chew hard foods and candy. For breast or bottle-fed babies: Liquid supplements are the best option. There are liquid preparations that give the recommended intake of 400 IU in ½ or 1 mL.
There are also liquid drop solutions available that provide one drop that equals 400 IU per day.As with all medications and supplements, vitamin D supplements should be kept out of a child's reach. In addition to vitamin supplements, enriched foods are another way to increase the vitamin D in your child's diet. Look for foods fortified with vitamin D such as milk, cereal, orange juice, yogurt, and margarine. Vitamin D is found naturally in only a few foods. See natural sources listed in the chart below. How to make sure your child is getting enough vitamin D: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 32 ounces per day of vitamin D-fortified formula or milk, should receive a vitamin D supplement of 400 IU a day. Adolescents who do not get 600 IU of vitamin D per day through foods should receive a supplement containing that amount.
Children with an increased risk of vitamin D deficiency, such as those taking certain medications and with chronic diseases such as cystic fibrosis, may need higher doses of vitamin D. Consult your pediatrician. While breastfeeding is the recommended method of infant feeding and provides infants with necessary nutrients and immune factors, breast milk alone does not provide infants with an adequate intake of vitamin D. Most breastfed infants are able to synthesize additional vitamin D through routine sunlight exposure. However, published reports of cases of vitamin D deficiency rickets among breastfed infants in the Unitied States caused researchers to take another look at whether all breastfed infants were getting adequate vitamin D. Vitamin D deficiency rickets among breastfed infants is rare, but it can occur if an infant does not receive additional vitamin D from a vitamin supplement or from adequate exposure to sunlight. A number of factors decrease the amount of vitamin D a person will synthesize from sunlight.
Living at high latitudes (closer to the polar regions), particularly during winter months Air quality conditions: high levels of air pollution Weather conditions: dense cloud covering The degree to which clothing covers the skin Skin pigmentation: darker skin types A supplement of 400 IU per day of vitamin D is recommended for all breastfed infants. American Academy of Pediatrics, November 2008 Furthermore, there exists a major public health effort to decrease the risk of skin cancer by encouraging people to limit their sunlight exposure (visit: Skin Cancer.) As a result, in April 2003, the American Academy of Pediatrics (AAP) published guidelines for vitamin D intake, recommending that all infants have a minimum intake of 200 IU of vitamin D per day, beginning during the first 2 months of life. In November 2008, the AAP published a new statement to replace their 2003 guidelines. The 2008 report recommends a daily intake of vitamin D of 400 IU/day for all infants and children beginning in the first few days of life.