Vitamin D Recommendations

• All infants and children up to 18 years require 400 IU of vitamin D per day.  Infants and children over 6 months can take 600 IU/day.
• All infants taking less than 33 ounces of formula per day (do not count breast milk) should be supplemented with 400 IU a day of Vitamin D, beginning in the first few days of life.  (There is 100 IU of vitamin D in each 8.3 ounces in formula, none in breast milk.)
• Children who do not obtain 400 IU of Vitamin D per day through foods should receive a supplement.  Since they would need 33 ounces of milk per day, and we limit milk to 24 oz or less, this includes most kids!  Supplements with both vitamin D and calcium are preferred.
• Children with increased risk of Vitamin D deficiencies, such as those taking certain medications, may need higher doses of Vitamin D.
• Breastfeeding mothers (and probably all of us!) should take vitamin D supplements in an adult form as well as give it to their infants in liquid form.
• See the article under "Related Documents" at the bottom of the page for more information from Scientific American.  The article goes through how we can make vitamin D as well as how to get it from food sources.  It also explains the benefits of this "vitamin" and diseases that evolve from deficiency.  Note:  This article is from 2007, before the recommendations of Vitamin D supplementation increased.

Why these recommendations?

Vitamin D is essential for getting calcium into bones and for overall health, but it is difficult to get enough Vitamin D from diet alone.  Foods with Vitamin D include infant formula, oily fish (salmon), cod liver oil, fortified milk and orange juice, and irradiated mushrooms.  The FDA has recently reported that the Vitamin D in milk is less than 50% of what the label states.  If you are Vitamin D deficient, you can use only about 10% of your calcium.  Studies show that up to 50% of 9-11 year olds (a time of rapid growth and bone changes!) are Vitamin D deficient.  Twenty percent of adolescents are Vitamin D deficient.  It is known that Vitamin D levels are lower in climates with less sun, in people with more skin pigmentation (which blocks sun absorption), and in people who use clothing or sunscreen to block most sunlight.  Vitamin D not only protects against weak bones (rickets in infants/toddlers, osteopenia in older children/adults), but may offer protection against depression, type 1 diabetes mellitus, multiple sclerosis, susceptibility to infections, and prevention of some cancers.

Minimum and Maximum Daily Vitamin D Supplements:

How can we give Vitamin D?

• For infants and young children, you can purchase a liquid formulation of Vitamin D over the counter in most pharmacies.  A common brand is Tri-Vi-Sol (vitamins A, D, and C), but there are others available as well.  Follow package directions for the brand you choose. 
• Older children and adults can take calcium and Vitamin D supplements in gummy chews, chocolate chews, or tablets.  Fish oil from cod liver (not all fish oils!) also contains vitamin D. 
• Multivitamin supplements often do not contain enough Vitamin D.  A separate supplement with vitamin D might be required.
• Pharmacies, health food stores, and vitamin stores sell many varieties of vitamin D.  Be sure it has at least 400 IU of Vitamin D and find a taste your child will take.
• A large majority (90-95%) of our Vitamin D comes from sunlight because it is difficult to get from diet.
• Sensible sunlight is probably the most reliable form of Vitamin D.  It must be sensible to avoid overexposure leading to sun damage to the skin (burns, skin cancer).  The amount of sunlight needed for adequate Vitamin D levels is difficult to prescribe because it depends on time of year, location in the world, time of day, skin pigmentation, and other factors.  It is estimated that 10 minutes per day for light skinned persons and 20 minutes per day for darker pigmented skins three days per week would be sufficient.  Continue to avoid the sun at peak intensities (10 am-2 pm).
• Pet stores sell reptile lamps that emit UVB.  Some experts recommend exposing the abdomen or legs to these lamps for 3-5 min/day.
• For more information, see the NIH guidelines.
  

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