Vitamin D supplementation in infants and children

The risk for vitamin D deficiency is increased when there is limited exposure to sunlight or when an infant is not consuming an adequate amount of vitamin D. Although reducing sun exposure is important for preventing cancer, it also decreases the amount of vitamin D that a person can make from sunlight. So, most infants and children will need vitamin supplements to meet the higher recommendations for vitamin D.

• The American Academy of Pediatrics recommends 400 IU/day starting just days after birth and continuing through adolescence.

Many infants and children don't get enough vitamin D and there are not many dietary sources of vitamin D. Milk and infant formula are the best sources, but they only contain 100 IU of vitamin D per cup. This means that only babies and children who drink at least one quart or liter a day of formula or milk get enough vitamin D. Everyone else needs supplements including breastfed babies (should receive 400 IU of supplemental vitamin D daily).

• For infants, recommend drops such as Vidrop 2800 IU/ML (CHOLECALCIFEROL = VITAMIN D) ORAL DROPS 15 mL, so give 4 drops (400 IU/day) as 1 mL (28 Drop) contains 2800 IU (1 drop = 100 IU) to prevent vitamin D deficiency.
• For older kids, recommend an appropriate multivit or supplement.

But advise parents not to overdo it. Tell them not to exceed 1000 IU/day for infants under 12 months or 2000 IU/day for older children and adults.

Vitamin D Supplementation in Children

Supplementation of 400 IU per day is recommended for...

• All breastfed infants unless they are weaned to a minimum of 1 L per day (33.8 fl oz) of vitamin D–fortified formula or milk.
• All infants who are NOT breastfed and who are ingesting less than 1 L per day of vitamin D–fortified formula or milk.
• All children and adolescents who do not get regular sunlight exposure; who do not ingest a minimum of 1 L per day of vitamin D–fortified formula or milk; or who do not take a daily multivitamin supplement containing at least 400 IU of vitamin D.

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References

1. Lee JY, So TY, Thackray J. A review on vitamin d deficiency treatment in pediatric patients. J Pediatr Pharmacol Ther. 2013;18(4):277-291.
2. Casey CF, Slawson DC, Neal LR. VItamin D supplementation in infants, children, and adolescents. Am Fam Physician. 2010;81(6):745-748.
3. Bordelon P, Ghetu MV, Langan RC. Recognition and management of vitamin D deficiency. Am Fam Physician. 2009;80(8):841-846.

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