The American Academy of Pediatrics (AAP) announced earlier today that it has doubled the recommended amount of vitamin D for infants, children, and adolescents. The decision to increase daily dosage is an update of the 2003 AAP initiative that sought to combat the childhood disease rickets. The minimal recommended dose for vitamin D supplementation has now increased from 200 international units (IU) to 400 (IU) per day, and should begin within the first few days of life. The new guidelines will be laid out in full in the November issue of Pediatrics.
Rickets, a weakening of the bones, has plagued child health care for centuries, and has yet to be eradicated. As bones are weakened, they do not form correctly, which can lead to twists and deformities of the skeletal system. The children most at risk are those who are breast-fed without vitamin D supplementation.
"Breastfeeding is the best source of nutrition for infants. However, because of vitamin D deficiencies in the maternal diet, which affect the vitamin D in a mother’s milk, it is important that breastfed infants receive supplements of vitamin D,” said Carol Wagner, MD, FAAP, member of the AAP Section on Breastfeeding Executive Committee and co-author of the report. “Until it is determined what the vitamin D requirements of the lactating mother-infant dyad are, we must ensure that the breastfeeding infant receives an adequate supply of vitamin D through a supplement of 400 IU per day.”
Proper amounts of vitamin D are essential throughout childhood, acting to reduce the rist of osteoporosis later in life. The idea that vitamin D is an essential feature for the well-being of childhood development is certainly not a new one. It extends back to spoonfuls of cod liver oil, which some of us remember with a pinch of the nose. The new recommendations for vitamin D supplementation are based on a clinical precedence for safety that has been established for administering 400 IU per day. (400 IU a day is actually the amount of vitamin D in a teaspoon of cod liver oil by the way!)
It is believed that 400 IU of vitamin D per day will not only prevent rickets, but it will help treat populations already afflicted with the disease. Dietary sources for vitamin D are not plentiful, so the AAP is recommending that all children be given vitamin D supplements.
Here are some of the guidelines for the new AAP recommendations:
- Breastfed and partially breastfed infants should be supplemented with 400 IU a day of vitamin D beginning in the first few days of life.
- All non-breastfed infants, as well as older children, who are consuming less than one quart per day of vitamin D-fortified formula or milk, should receive a vitamin D supplement of 400 IU a day.
- Adolescents who do not obtain 400 IU of vitamin D per day through foods should receive a supplement containing that amount.
- Children with increased risk of vitamin D deficiency, such as those taking certain medications, may need higher doses of vitamin D.
For more info check out the AAP press room release, New Guidelines Double the Amount for the Recommended Vitamin D, and the AAP Clinical Report,
Prevention of Rickets and Vitamin D Deficiency