What Does Vitamin D Do
Vitamin D helps the body appropriately absorb and regulate calcium, which is essential for bone health. Without enough vitamin D, kids may suffer from weak or brittle bones that break easily. They can also develop rickets, a bone condition caused by severe vitamin D deficiency. Rickets can lead to bowed legs and stunted growth.
“The primary function for vitamin D, the one we focus on the most, is bone health,” explains Dr. Barlow. “Vitamin D acts almost like a construction site supervisor. It makes sure the materials we need for strong bones such as calcium and phosphate are where they need to be, and in the correct amounts.”
Overall Aims And Research Questions
The aim of the study is to investigate long-term health benefits of early vitamin D supplementation with a dose ensuring effective concentration of 25-OHD.
The primary outcomes of the study are bone strength and cumulative frequency of infections at 24 months of age. We hypothesise that a higher vitamin D supplementation to infants between 2 weeks and 24 months of age will increase bone strength and decrease the frequency of infections.
Secondary outcomes of the study are occurrence of IgE mediated allergic symptoms, growth, motor, cognitive and social development, and associations of concentration and effects of vitamin D with polymorphisms of genes associated with its synthesis, binding proteins and degradation.
Vitamin D With Sun Exposure
Your skin makes vitamin D when exposed to the sun, so it can be a great way to get vitamin D, however, there are a few caveats:
- People living in higher latitudes will not make as much vitamin D from the sunlight as people living closer to the equator.
- Those with darker skin will make less vitamin D than those with lighter skin.
- People living in places with dense cloud or smog cover will make less.
- The use of sunscreen and full clothing impairs vitamin D production however its recommended to always use sunscreen when out in the sun to prevent skin cancer.
- Children under 6 months should not be exposed to direct sunlight.
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Vitamin D For Children
Vitamin D is often called the sunshine vitamin because it can be made in the skin from exposure to sunlight. Many people assume that we get an adequate amount of vitamin D simply from drinking milk and a little exposure to the outdoors, but research has found this may not be the case.
Certain factors such as lifestyle changes, sunscreen use, and changes in diet have led to the majority of the population showing signs of vitamin D deficiency. The American Academy of Pediatrics increased the amount of vitamin D recommended for children and adolescents in 2014 due to new research on the life-long health benefits of vitamin D.
Frequently Asked Questions On Vitamin D Supplementation For Infants
Given vitamin Ds important benefits for infants musculoskeletal, respiratory, and immune health, supplementation is generally recommended by pediatricians during infancy. Below are answers to frequently asked questions regarding vitamin D supplementation for infants. Since proper care and precautions should always be taken when providing infants with supplements, this information is best utilized as a guide for discussing supplementation with your childs pediatrician.
How much vitamin D should my breastfed baby take?
Because most women do not consume high amounts of vitamin D, the levels found in breast milk typically do not provide a sufficient amount for infants.24 For this reason, the American Academy of Pediatrics recommends that infants who are exclusively breastfed receive supplementation with 400 IU of vitamin D daily.2,25
However, research suggests that 400 IU/day might not be enough for all infants.26,27 For example, a study comparing the vitamin D levels of infants supplemented with either 400, 800, 1200, or 1600 IU/day of vitamin D found that after 3 months, only 55% of the infants receiving 400 IU/day had sufficient vitamin D levels . This is in comparison to 81%, 92%, and 100% of the infants from the 800, 1200, and 1600 IU/day groups, respectively.26 To find the right dose for your infant, talk with your pediatrician about testing options.
Can maternal vitamin D supplementation while breastfeeding provide an infant with enough vitamin D?
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Where Can Babies Get Vitamin D
Breastfed newborns and babies should take a vitamin D supplement prescribed by the pediatrician. Babies who are formula-fed may or may not need a supplement. Formula is fortified with vitamin D, and it may be enough to meet your baby’s daily needs. Check with your pediatrician about whether your formula-fed baby needs vitamin D drops.
Breastfed babies need to continue taking the vitamin D drops until they’ve transitioned to solids and are getting enough vitamin D that way .
Generally, once babies start solid foods, they can get vitamin D from other sources like milk, orange juice, fortified yogurt and cheese, salmon, canned tuna, cod liver oil, eggs, fortified cereals, tofu and fortified non-dairy milks like soy, rice, almond, oat and coconut milk.
If youre concerned that your baby isnt getting enough vitamin D or any other nutrient, you can also add in a daily multivitamin once your infant becomes a toddler.
While the AAP says most healthy children on a well-balanced diet will not need a vitamin supplement, if you’d like your little one to start taking a multivitamin, talk to your doctor about whether it’s right for your child and the best brands.
Signs Of Vitamin D Deficiency In Babies
Vitamin D deficiency isnt easy to spot in babies, partly because they cant tell you how theyre feeling. And fatigue and muscle pain, symptoms of vitamin D deficiency, are common symptoms of several other conditions. In addition, signs of vitamin D deficiency may not show up until months or years later.
But doctors may check your babys vitamin D levels if your baby has:
- Frequent illnesses or infections.
- Poor growth.
- Frequent bone fractures.
Dont wait to see if your baby has symptoms of vitamin D deficiency, Dr. Liermann says. Supplement Vitamin D regularly to prevent deficiency. And if you have any concerns about your babys health, talk to your pediatrician.
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What Is Vitamin D Deficiency
As the name goes, a lower level of Vitamin D in the body is termed as Vitamin D deficiency. Then what is Vitamin D insufficiency? Well, its the blood level of Vitamin D measured in the form of serum 25-hydroxy-Vitamin D that determines it. A level below 25 nmol/L is a deficiency and between 25-50 nmol/L is insufficiency. When the level is above 50 nmol/L, there is evidence of benefit to the bones, muscles, the immune system, and the insulin secretion.
Other Issues With Vitamin D Dosing In Infants
Some families are resistant to providing drops of vitamin D to their breastfed infants or perceive them to be poorly tolerated, especially when given with iron-containing multivitamins. In these cases, there are several alternatives that may be considered . The first is the use of vitamin D drops that can be placed directly on the breast or given as dissolvable filmstrips. For some mothers, this is easier and more acceptable than giving a dropper of vitamins directly to the infant or mixed in their milk .
Fig. 2.
Adequate and inadequate vitamin D metabolism in infants.
Another approach is to have the lactating mother take a relatively high dose of vitamin D. Studies have shown that a maternal dose of 6,400 IU daily will provide an infant with adequate vitamin D intake from the mothers milk if fully breastfed and if the mother takes the dose every day. Of note is that lower maternal doses, especially those of 4002,000 IU daily, do not provide adequate vitamin D in breast milk. The dose of 6,400 IU daily is slightly above the IOM upper limit of 5,000 IU/day but is highly likely to be safe, and this should not be a concern in recommending this approach if desired by breastfeeding women .
Table 2.
For additional information:
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Risks For Babies Who Lack Enough Vitamin D
When babies lack enough vitamin D, one potential consequence is weakened or softened bones. This can make a babyâs legs appear curved or bowed. Keep in mind that bowlegs are actually common in babies and toddlers but that this condition usually corrects itself before the age of 2. Bowlegs in babies and young toddlers is within the range of normal development and thought to be related to the tightly curled up position of babies in the uterus.
However, there are symptoms and conditions, including rickets, that can result from extreme vitamin D deficiency, and can hinder your childâs physical development. These may include:
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extreme curvature in the legs
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one leg curving more than the other
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bowlegs becoming worse after 2 years of age
-
knock-knees after 7 years of age
-
short height
-
seizures
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difficulty breathing.
Additionally, researchers have found correlations between vitamin D deficiency and certain diseases and conditions that could occur as babies get older and reach childhood or adulthood, such as
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colon, breast, or prostate cancers
-
hypertension
-
respiratory and viral infections
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autoimmune conditions, including multiple sclerosis and rheumatoid arthritis.
Although these diseases and complications sound scary, remember that they are rare. With the right supplementation, your baby will get the necessary nutrients to stay strong and healthy! If you have any questions or concerns, consult your childâs healthcare provider.
How Much Vitamin D Should Babies Have
Article at a glance:
Vitamin D is vital for growth, development and immune balance Babies are at higher risk of vitamin D deficiency because they must avoid full sun exposure Advice from UK Department of Health is that all children aged 0-4 should be given a daily supplement of 400 IU vitamin D Vitamin D is best supplemented as D3 – the form naturally made in the skin following sun exposure
Why do babies need to supplement vitamin D?
The main source of vitamin D is not food, but sunlight. And babies under the age of 6 months are advised to stay out of the sun completely so this puts them at particularly high risk of vitamin D deficiency. Babies under 6 months, and in fact all children under 4, are considered at higher risk and advised to supplement regularly.
Vitamin D is crucial for infants, not just to grow healthy bones and prevent the bone-softening disease rickets, but also for normal physical and brain development, immune balance, heart health and even to support optimal levels of friendly bacteria. Vitamin D helps to control the amount of calcium and phosphate in our bodies both of which are needed for healthy bones, teeth and muscles. It has antioxidant and anti-inflammatory actions and plays a crucial role in immune balance. There may even be links between vitamin D deficiency and risk of developing autoimmune problems such as type 1 diabetes and multiple sclerosis.
Do breastfed babies need vitamin D?
How about formula fed infants?
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What Are Good Food Sources Of Vitamin D
When it comes to Vitamin D content, not all foods are created equal. Many people associate vitamin D with sunshine, as it can be absorbed through the skin from the suns ultraviolet light, but you can also find it in certain foods. Some of the richest in vitamin D are oily, fatty fish, while some dairy foods offer lower amounts.
The table below provides a list of the most common dietary sources of vitamin D that you can add to your meal plans to help boost how much vitamin D you and your family are getting.
Vitamin D Supplementation Can Help Support Respiratory Health In Infants
In addition to musculoskeletal difficulties, insufficient vitamin D can also affect an infants developing immune system, placing them at a heightened risk of respiratory complications, flu, and allergies.8 Particularly concerning for infants, research shows that low levels of vitamin D are associated with respiratory tract issues that can potentially lead to chronic complications throughout life.911
However, research also suggests that vitamin D supplementation can help support respiratory health. For example, supplementing infants with vitamin D has been found to help reduce wheezing and promote normal, healthy respiratory tract functions.1214 Supplementation has also been found to limit the incidence of common allergies, such as eggs and peanuts.1214
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The Importance Of Vitamin D For Babies And Toddlers
Learn to recognize a range of vitamin D rich foods, healthy amounts to consume, and how to incorporate them into meals for the whole family. Weve pulled together a list of the best vitamin D food sources for you and your baby and some details on how supplements can benefit your little one with the answers to these FAQs.
Supplements For Babies At Risk Of Deficiency
If your baby is at high risk of vitamin D deficiency, talk to a health professional such as your doctor, midwife or dietitian. Your doctor can prescribe a vitamin D supplement that comes in drops.
Drops can either be:
- put on your nipple before your baby latches on
- given directly into your babys mouth using a dropper.
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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.
How To Prevent Vitamin D Deficiency In Children
In general, along with the supplementation if necessary, adequate sunlight exposure and consuming foods rich in Vitamin D will help augment the prevention strategy instead of mere supplements. Approximately, 5-15 minutes of sunlight exposure to the hands for light-skinned children and 30-45 minutes for dark-skinned children is helpful and natural. Preferably early morning sunlight is better as it has lower levels of harmful UV rays.
- Maternal Vitamin D:
The most important aspect that determines the Vitamin D level in infants is the Vitamin D status of the mother. Pregnant women should check their Vitamin D levels during the first trimester of their pregnancy. If found to be low it is best to be treated with 3000-5000 IU until it is more than > 20 ng/dL followed by 400 IU /daily.
High dose of Vitamin D administered every day to breastfeeding mothers protects the child from Vitamin D deficiency without causing Vitamin D toxicity to the mother of the child.
- Preterm infants:
-A supplement of 400-800 IU/day starting at birth is important as there is a possibility of inadequate transfer of Vitamin D from the mother.
-Other problems associated with prematurity like poor feeding ability, immature gastrointestinal tract affecting the absorption and in some cases liver and kidney impairment and should be tackled accordingly.
- Infants:
- Toddlers and adolescents:
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