Vitamin D Supplementation
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A supplement of 200 IU per day of vitamin D is recommended for all breastfed infants. American Academy of Pediatrics, April 2003 |
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 from 2000
and 2001 of cases of vitamin D deficiency rickets among breastfed infants
in North Carolina, Texas, Georgia, and the mid-Atlantic region 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.
These factors include
- 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
- Use of sunscreen
- Skin pigmentation: darker skin types
Furthermore, there exists a major public health effort to decrease
the risk of skin cancer by encouraging people to limit their sunlight
exposure (visit:
www.cdc.gov/cancer/nscpep/index.htm.)
As a result, in April 2003, the American Academy of Pediatrics (AAP)
published new 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.
Human milk typically contains a vitamin D concentration of 25 IU per
liter or less. Therefore, a supplement of 200 IU per day of vitamin D is
recommended for all breastfed infants. Adequate amounts of vitamin D can
be achieved by currently available multivitamin products containing 400
IU of vitamin D per mL. These products are available over the counter.
Currently there are no over the counter preparations containing vitamin D
alone without other vitamins. Prescription preparations of vitamin D
have very high vitamin D concentration and are not for routine home use.
If an infant is weaned to vitamin-D fortified infant formula (consuming
at least 500 mL per day) or a child one year of age or older is weaned
to vitamin-D fortified milk, then further supplementation is not
necessary.
To review the AAP guidelines on vitamin D intake published in Pediatrics April 2003, 111(4):908–910, visit http://aappolicy.aappublications.org/cgi/content/full/pediatrics;111/4/908*
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Page last updated: May 22, 2007
Content Source: Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion