Ask Dr. Marla: How can I make sure my children get enough Vitamin D?

By Dr. Marla Shapiro on September 23, 2014

 

Question

Now that it's getting cooler and we're not spending as much time outside, how can I make sure my children get enough Vitamin D? Do they need a supplement?

Answer

We have been focused on vitamin D and adults so this is a great question that will bring attention to the issue of Vitamin D and children. Vitamin D is essential for healthy bones. There is emerging evidence as to the role of Vitamin D and protection from chronic diseases, but that is evolving research.

Our pediatric societies do in fact recommend Vitamin D supplements for infants, children and adolescents. We also supplement breastfed babies. Unless a newborn is drinking 32 ounces of an infant formula on a daily basis, they will require supplementation as well.

Typically the child dose is 400 IU of Vitamin D and that can be found in both liquid and chewable preparations.

Vitamin D can also be found in either fortified or enriched foods. Fortified foods include milk, certain cereals (read the labels), some orange juices and yogurts. It’s hard to find Vitamin D in our foods but they are present in oily fish, liver, cheese and egg yolks. As an example, 3.5 ounces of salmon gives you as much as 90 percent of the daily recommended value, whereas an egg will only give you six percent of the daily amount your child needs.

While your child is playing outside, we encourage you to use sunscreen at all times. As a result you would have to assess your child’s diet to review the need a supplement. The American Academy of Pediatrics reminds us that breastfed and partially breastfed children should be supplemented with 400 IU a day of the vitamin. Any non-breastfed child or older child who has less than the 32 ounces of fortified formula or milk should receive a supplement as well. This holds true for adolescents who may not be getting adequate amounts through foods. They too should be taking a supplement. A cup (eight ounces) of Vitamin D-fortified milk, regardless if non-fat, reduced fat or whole milk, has 98 IU and 25 percent of the daily recommended amount of Vitamin D.

The Canadian Paediatric Society points out that there are few studies related to vitamin status in toddlers and older infants. And you're right that the time of year, latitude and the use of sunscreen are all factors that will influence sun exposure and therefore levels of Vitamin D. In infants and children living in the north, supplementing with 400 IU appears to be safe but we do see Vitamin D deficiency, particularly in this group. Overweight and obese children are also at higher risk of Vitamin D deficiency

As always, speak with your healthcare provider to get the best advice for your child.


Originally published in ParentsCanada magazine, October 2014.

By Dr. Marla Shapiro| September 23, 2014

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