In my practice I recommend vitamin D supplementation from the first visit with families. Since the 1980s, there has been a rising trend of vitamin D deficiency. I think it is an important supplement for all family members. Did you know that vitamin D is essential for calcium absorption and bone health? This is super important for all children who are growing and developing. Vitamin D is important for growing bones and cartilage in children to help them meet developmental milestones, grow to their fullest potential and decrease infection risks. In older children and adolescents this vitamin is important to keep bones strong and prevent fractures, pain and weakness.
The recommendations per the American Academy of Pediatrics: 400 international units daily of vitamin D3 for all infants under 1 year old and 600 international units daily for all children 1 year to 18 years old.
What are natural sources of vitamin D? Fatty fish: salmon, mackerel, and sardines; cod liver oil, liver, organ meats, and egg yolk. In the United States some foods are fortified with vitamin D: milk and milk products, orange juice, bread, and cereals. Why is this not enough? #1 most young children do not eat fatty fish or organ meats. #2 Someone must drink 32 ounces of milk daily to meet the recommended dietary intake. NO ONE should drink more than 8-16 ounces of milk daily. Milk, while rich in calcium and vitamin D fortification can deplete the other nutrients from healthy foods such as fruits, veggies, meats, nuts, beans and eggs if too much is consumed daily. Also, too much milk and dairy products can cause constipation (a topic for another blog 😉
Can I get vitamin D from the sun? Theoretically yes, however, the sun has to be at a specific latitude and longitude at the right time of day and vitamin D absorption from the sun is inconsistent. Furthermore, sunscreen prevents absorption. So needless to say, the sun is NOT the optimal source of vitamin D. Recently, Dr Eichenfield of Rady Children’s hospital in the San Diego Magazine discouraged unprotected sun exposure due to the risk for skin cancer. So supplementation it is!
Too much vitamin D is rare and if your child is taking the above recommended daily supplement, they will not consume too much vitamin D. Any vitamin brand that supplements 400 IUs daily for infants and 600 IUs for children over 1 year old is appropriate. Some of my favorite brands include: the honest company, garden of life, and smarty pants. If taking chewable vitamins make sure your kiddos brush their teeth afterwards to protect them from cavities!
To health and wellness,
Jennifer Ragusa PNP
Information sourced from uptodate:Vitamin D insufficiency and deficiency in children and adolescents and AAP.