Vitamin D Supplementation
A supplement of 400 IU per day of vitamin D is recommended for all breastfed infants. American Academy of Pediatrics, November 2008 |
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.
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 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.
Human milk typically contains a vitamin D concentration of 25 IU per
liter or less. Therefore, a supplement of 400 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 or the newly available preparations that contain
400 IU/mL vitamin D alone without other vitamins. These products are available over the counter.
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 1000 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 new AAP clinical report on vitamin D intake published in Pediatrics November 2008, 122(4):908–910, visit http://aappolicy.aappublications.org/cgi/content/full/pediatrics;122/5/1142*
Please note: Some of these publications are available for download only as *.pdf files. These files require Adobe Acrobat Reader in order to be viewed. Please review the information on downloading and using Acrobat Reader software.
* Links to non-Federal organizations found at this site are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization Web pages found at these links.
Page last updated: December 1, 2008
Content Source: Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion