Babies Need More Vitamin D

Pediatric group changes recommendation due to increase in rickets

MONDAY, April 7, 2003 (HealthDayNews) -- To prevent vitamin D deficiency and the bone-softening disorder rickets, the nation's leading group of child doctors is recommending that many infants and children be given daily vitamin D supplements.

The recommendation from the American Academy of Pediatrics (AAP) comes in part, ironically, because parents are doing other things to keep their children healthy.

In a report in the April issue of Pediatrics, AAP experts explain that because more cases of rickets are being reported, all babies and children should get at least 200 international units (I.U.) of vitamin D daily if they're not getting enough vitamin D from other sources.

"Infants and young children need a source of vitamin D, and the safest way to be certain they are getting enough is to give the [vitamin] drops until they are drinking enough formula or vitamin D-fortified milk," says Dr. Nancy Krebs, chairwoman of the AAP's committee on nutrition and an associate professor of pediatrics at the University of Colorado Health Sciences Center in Denver.

Sixteen ounces, or a pint of infant formula or vitamin D-fortified milk, will provide a sufficient amount of vitamin D, Krebs says. If your baby, child or teenager isn't consuming that much milk or formula, they should take 200 I.U. of vitamin D daily.

For older children, most multivitamins contain at least that amount. For infants, your doctor can prescribe liquid vitamins.

Rickets is a disorder caused by vitamin D deficiency. Bones become soft and weak. If the condition isn't treated, it can cause skeletal deformities and short stature. The problem, according to Krebs, is that you can be vitamin D deficient for a long time before symptoms appear.

Many infants and children today don't get enough vitamin D for several reasons.

The first is that more women are choosing to breast-feed. While breast-feeding is beneficial in many ways for infants, breast milk lacks significant amounts of vitamin D. That doesn't mean women shouldn't breast-feed, however.

"Breast-feeding is the unquestionably optimal way to feed a young infant," Krebs notes.

The second reason is that people are avoiding the sun. In the past, a major source of vitamin D was the sun. When exposed to ultraviolet light, the body produces vitamin D. But health professionals now know the same ultraviolet light that makes vitamin D can also cause skin cancer. So people are staying out of the sun altogether or wearing sunscreen, which prevents the ultraviolet light from getting through.

"Supplements provide a way to meet the vitamin D needs while minimizing exposure to potentially damaging ultraviolet light," Krebs says.

Dr. Bella Silecchia, a pediatrician at Nassau University Medical Center in East Meadow, N.Y., says she already recommends vitamin drops for babies that contain vitamins A, C and D, and she believes most pediatricians probably do likewise.

She says parents "need to be aware that in protecting your children from sun exposure, you don't allow the body to be a source of vitamin D." Silecchia adds that while rickets is on the rise, it can be prevented with adequate vitamin D intake.

Krebs says the committee carefully considered the recommended dose because too much vitamin D can be toxic. The recommended 200 I.U. a day for those not drinking a pint of milk or formula is about 10 times less than the toxic dose, Krebs says.

More information

To learn more about rickets, visit the National Library of Medicine. For more information on vitamin D, go to the National Institutes of Health.

SOURCES: Nancy Krebs, M.D., chairwoman, American Academy of Pediatrics Committee on Nutrition, and associate professor, pediatrics, University of Colorado Health Sciences Center, Denver; Bella Silecchia, M.D., pediatrician, Nassau University Medical Center, East Meadow, N.Y.; April 2003 Pediatrics
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