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Rickets, seizures and low calcium levels. What do all of these have in common? They can be triggered by a severe nutritional vitamin D deficiency. These conditions can hospitalize infants, as well as children on restrictive diets, who lack the proper amount of vitamin D in their diets. Fortunately, this is easily prevented by the appropriate vitamin D intake through food or supplements.

Current recommendations state that all newborns need vitamin D supplementation whether they breast or bottle feed to keep vitamin D at a healthy level and prevent hospitalization and adverse health conditions.

Why do infants need vitamin D?

Vitamin D is crucial for building strong bones and maintaining normal calcium levels in the blood. Since children are actively building new bone as they grow, normal levels of Vitamin D are extremely important.

Prolonged and severe lack of vitamin D can lead to serious medical conditions, but even a mild deficiency can adversely affect a child. While early vitamin D deficiency may not show symptoms, severe deficiency can lead to:

• Poor growth
• Rickets – symptoms include refusal to walk or delayed walking, leg pain, swelling of wrists and ankles and delayed closure of soft spot on an infant’s head
• Low calcium levels – symptoms include jitteriness, seizures and irregular heart rhythm

Vitamin D Supplement Options

The current vitamin D recommendation is 400 IU/day for all infants from birth to 12 months of age. IU stands for international units, which is the standard way of reporting vitamin D amount in foods and supplements.

Vitamin D supplements are available over the counter in a wide variety of forms – drops, gummies, tablets, capsules, etc. Two main differences between the various supplements are the types of vitamin D – whether vitamin D2 (plant-source) or vitamin D3 (animal-sourced) – as well as how much vitamin D is contained in the supplement type.

While vitamin D deficiency has negative effects on children, vitamin D in excess can also be very dangerous. It is important to always consult with your pediatrician to determine which type of supplement and how much vitamin D is appropriate for your child.

Vitamin D for Older Children

While vitamin D can be made in our skin naturally by sun exposure, most of us do not get adequate sun exposure and have to get adequate vitamin D through our diet. Vitamin D-rich foods include:

• Egg yolks
• Milk (almost all dairy milk has same amount of added vitamin D)
• Yogurt
• Mushrooms
• Salmon
• Orange juice
• Oatmeal

While infants under 1 year are at highest risk for vitamin D deficiency, older children can be at high risk if they have certain conditions that reduce the intake of vitamin D including:

• Children with restrictive diets not eating vitamin D and calcium-rich foods regularly (for example: children with autism, problems eating foods with certain textures or dairy intolerance)
• Children with poor absorption or increased needs of calcium and/or vitamin D (for example: underlying chronic GI illness or therapy with certain anti-epileptics)

Beyond 12 months of age, children need 600 IU/day of vitamin D through their diet and/or a supplement.  Children with certain health conditions may have higher vitamin D needs. Consult with your pediatrician if you have questions or concerns about your child’s vitamin D intake.

Ensuring that your child has the proper amount of vitamin D is key for healthy bones and prevents complications of low vitamin D level.