Vitamin D Intake And Function
The relationship between dietary intake of vitamin D and serum 25D levels has been evaluated both in preterm and full-term infants for many years. There are far fewer data relating 25D levels and bone mineral content or density in preterm infants or even fracture rates in these infants. Some data suggest a possible benefit for higher 25D levels on bone mineralization but need confirmation in larger trials and correlation with clinical events and outcomes . There are no data indicating that doses of vitamin D of 400 IU daily, or serum 25D achieved with those doses, are associated with an increased risk of rickets or fractures in any population of preterm or full-term infants.
Most data in infants, both preterm and full term, do not specifically allow for an understanding of the relationship between body weight and dose-response of vitamin D intake. The IOM report considered these relationships related to age but not specifically for infants . Although cutaneous production of vitamin D exists in infants, this too is generally minimally considered in most research as it is extremely hard to quantify, and the use of sunblock as well as other factors limiting sun exposure make this an unreliable source of vitamin D for infants. Recommendations for vitamin D intake, including those of the IOM , are generally done on the assumption that cutaneous conversion of pro-vitamin D to vitamin D in infants is minimal or nonexistent.
Should Pregnant Women Take Vitamin D Supplements
How much vitamin D you get while youre pregnant will affect how much vitamin D your baby has at birth. A baby born to a mother who is vitamin D deficient is more likely to also have a deficiency.
You are more likely to be vitamin D deficient if:
- you dont use products like milk and margarine, which in Canada are fortified with vitamin D.
- you don’t have much exposure to the sun.
- your skin is covered with clothing or sunscreen much of the time.
- you have darker skin.
- you live in a northern community .
If you are pregnant, talk to your doctor about whether a supplement of up to 2000 IU/day is right for you.
Do Breastfed Babies Really Need Vitamin D
We often hear that breast milk is a complete food, containing everything your baby needs. But tests have shown that breast milk is lacking in vitamin D.
Infants should get vitamin D drops starting in the first few days of life, Dr. Liermann says. Its especially important in breastfed babies because they get minimal, if any, vitamin D from breast milk.
Infant formula contains vitamin D, but its not enough for younger babies. Formula-fed babies need a vitamin D supplement until they are taking 32 ounces of formula every day, says Dr. Liermann. This usually happens after the first few months of life, but is different in every baby. Newborns, in the first few months of life, dont consume enough formula to get the recommended daily amount of vitamin D.
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How Do We Get Vitamin D
Vitamin D comes from different sources:
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Sunlight: Vitamin D is formed naturally when skin is exposed to sunlight. Because Canada is located so far north, sunlight isnt enough at certain times of the year. Also, darker skin, sunscreen and clothing, which protect babies from the harmful effects of the sun, wont allow vitamin D to be formed.
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Foods: In Canada, vitamin D is added to cows milk and margarine during production. Some plant-based beverages may have vitamin D added. Some foods fatty fish like salmon, tuna, trout and whitefish, and egg yolksare also sources of vitamin D.
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Vitamin supplement: For babies, it comes in liquid form and is given daily with a dropper. Its important to give your baby a supplement that is meant for babies. Read the instructions carefully to be sure you give your baby the right amount. If you are unsure, talk to your pharmacist.
How Much Sun Do Children Need To Make Vitamin D
Heres a guide to how much sun your child needs to make vitamin D, without putting your childs skin at risk of sun damage.
In Brisbane and Darwin, right through the year, a few minutes most days of the week should be enough.
In Canberra, Perth and Sydney:
- in June and July, 2-3 hours per week should be enough
- in summer, a few minutes most days of the week should be enough.
In Adelaide, Hobart and Melbourne:
- from May to August, 2-3 hours per week should be enough
- in summer, a few minutes most days of the week should be enough.
Be sun smart No matter where you live in Australia, you have to be careful about how much sun children get on their skin. Too much sun can lead to sunburn, skin damage and even skin cancer. This is why its important to use sun protection.
During summer, especially between 10 am and 4 pm, make sure your child stays safe in the sun with sunscreen, a hat, sunglasses, clothing that keeps the sun off, and access to plenty of shade.
To get more information and advice about how much sun is right for your child, speak with your GP.
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Specific Groups At Increased Risk
Some mother and infant groups have been shown to be at increased risk, including:
- Babies of mothers with darker skin types
- Pregnant and breastfeeding women.
- Babies born in the winter months and not exposed to the sun
- Babies and mothers who wear concealing clothing, preventing skin exposure to sunlight
- Babies and mothers who spend a lot of time indoors or use sun creams, reducing exposure to sunlight
- Babies of obese mothers
- Babies of mothers with gestational diabetes.
Babies May Get Too Much Vitamin D From Droppers
FDA Says Some Droppers Give Infants Excessive Doses of Liquid Vitamin D
June 15, 2010 — The FDA is warning parents and caregivers of infants that some liquid vitamin D supplement products sold with droppers could allow excessive doses to be given to babies, which could be harmful.
The FDA says some droppers that come with the vitamin D liquid could hold more than the 400 international units a day recommended by the American Academy of Pediatrics.
“It is important that infants not get more than the recommended daily amount of vitamin D,” Linda M. Katz, MD, MPH, of the FDA, says in a news release. “Parents and caregivers should only use the dropper that comes with the vitamin supplement purchased.”
Excessive vitamin D can cause nausea and vomiting, loss of appetite, excessive thirst, frequent urination, constipation, abdominal pain, muscle weakness, muscle and joint aches, confusion, and fatigue and even cause serious damage to kidneys, the FDA says.
Vitamin D in proper doses is necessary for infant development, promoting calcium absorption in the gut and strong bone development. Vitamin D supplements are recommended for some infants, especially those who are breastfed, because deficiency can lead to bone problems, such as thinning, soft, and misshapen bones such as seen in the condition known as rickets.
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Dietary Sources Of Vitamin D And Timing Of Introduction
Because neonatal vitamin D status is reflective of maternal status, it has been suggested that it is best to start supplementation as early as is possible . As such, whereas earlier recommendations in full-term infants suggested waiting until up to 6 weeks to allow lactation to become well-established, more recently, it is recommended that vitamin D be started within the first few weeks if not the first days of life.
One important reason for this is that it is easier and more reliably performed to teach families to properly give the drops to their breastfed infant while still in the hospital as it is less likely to be missed if begun in the hospital. In some hospitals, the first bottle of the drops may be sent home with the family. The opportunity to rapidly increase very low 25D levels in infants born to mothers with very low levels is also a reason to consider this. However, it should not be expected that there will be specific clinical benefits to beginning vitamin D in the first weeks of life, and if some families wish to delay giving drops for 46 weeks until lactation is well-established that should be considered as reasonable.
How Much Vitamin D Do Babies Need
The American Academy of Pediatrics recommends a daily intake of 400 IU for babies. Most infant vitamin D supplements contain this amount in one dose. But the dose could be different, depending on which brand of drops you buy.
Some supplements have 400 IU in one drop, but others have 400 IU in a dropperful, says Dr. Liermann. Whatever supplement you choose, be sure it says its for infants. Follow the dosing instructions carefully. If you dont know which kind to use, ask your childs pediatrician.
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Do A Mother’s Prenatal Vitamins Have Enough Vitamin D For Babies
Nursing moms should keep taking their prenatal vitamin while breastfeeding, but the supplement doesn’t contain enough vitamin D to meet your babys needs. Thats why breastfed babies need vitamin D drops until theyre able to get enough through their own diets. The typical prenatal vitamin only contains 600 IUs, which isnt nearly enough to cover both Mom and baby.
That said, moms who supplement with 4,000 IUs of vitamin D daily have breast milk that will typically contain 400 IUs per liter or 32 ounces. But since newborn babies are unlikely to take a full feeding of breast milk, you’ll need to give them a vitamin D supplement at least at first to ensure that your baby is getting enough until she takes a full feeding.
Though that’s not a practice new moms generally follow, most experts say it’s safe. But always check with your pediatrician and OB/GYN to make sure what you’re doing is enough for your child.
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.
Where Does Vitamin D Come From
The Sun
Our bodies make vitamin D when our skin is exposed to the sun. It’s hard to get enough vitamin D from the sun, though. Most kids and adults spend lots of time indoors at school and work. When outdoors, it’s important to protect skin to prevent skin cancer and skin damage from too much sun exposure.
Food
Very few foods have vitamin D naturally. The foods with the most are fatty fish , liver, eggs and fish oils. Kids don’t eat these foods a lot. That’s why food companies add vitamin D to milk, yogurt, baby formula, juice, cereal, and other foods.
Adding vitamin D to foods is called “fortifying.” It’s helpful, but it still may not be enough.
Supplements
To get enough vitamin D, children often need to take a multivitamin with vitamin D or a vitamin D supplement. Vitamin D is sometimes labeled as vitamin D3.
You can buy vitamin D pills, gummies, chewables, liquids, and sprays in stores without a prescription. Ask your child’s health care provider for advice on choosing the right one.
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Why Do Breastfed Babies Need A Vitamin D Supplement
Breast milk is the best food you can offer your growing baby. Even when your baby starts eating other foods, you can continue to breastfeed until 2 years of age and beyond.
But breast milk only has small amounts of vitamin D , which may not be enough to meet your babys needs. Babies who are breastfed should receive a daily supplement of vitamin D from birth until they get enough from their diet.
Where To Get Vitamin D Supplements
Those who are eligible for Healthy Start vouchers receive free vitamin tablets and drops containing the correct dose of vitamin D for mothers and children.
Those not eligible for Healthy Start may purchase vitamin supplements form pharmacies and Health Food Stores please check that they contain 10µg for adults and at least 7-8.5µg for children .
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What Causes A Deficiency In Vitamin D
The best source of vitamin D is sunlight. The exact amount of sunlight people need to make enough vitamin D depends on their skin color, the time of day theyre outside, and the time of the year.
When ultraviolet rays from the sun hit the skin, it triggers your body to synthesize vitamin D. Once in your body, vitamin D needs to be activated through a process known as hydroxylation.
A vitamin D deficiency is usually caused by not getting enough sunlight.
Pregnant or nursing mothers dont usually get enough vitamin D to provide for both themselves and their babies. This is why babies who are exclusively breastfed are at a higher risk of vitamin D deficiency. Breast milk contains very little vitamin D.
How Can I Help My Child Get Enough Vitamin D
Because vitamin D is so important, you’ll want to be sure your child gets enough. Giving your child a daily supplement or a multivitamin with vitamin D is the easiest way to do this.
Health care providers might order a blood test if they think a health problem is keeping a child from getting enough vitamin D. If doctors don’t think your child has a health problem, there’s no need for a blood test.
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Do Infants Get Enough Vitamin D From Breast Milk
Breast milk alone does not provide infants with an adequate amount of vitamin D. Shortly after birth, most infants will need an additional source of vitamin D.
To avoid developing a vitamin D deficiency, the Dietary Guidelines for Americans and American Academy of Pediatrics recommend breastfed and partially breastfed infants be supplemented with 400 IU per day of vitamin D beginning in the first few days of life. Families who do not wish to provide a supplement directly to their infant should discuss with a healthcare provider the risks and benefits of maternal high dose supplementation options.
Why Your Breastfed Baby Needs Vitamin D
Youve chosen to breastfeed your baby. After all, its the best choice for feeding your newborn. But youve also been told to add a vitamin D supplement your childs diet. Vitamin D supplements, usually through easy to swallow drops, play an important role in your babys developing health. Infant formula is fortified with vitamin D, but if your child is breastfed, they may not be getting enough of this important vitamin.
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