As we say goodbye to daylight savings time, it’s a great time to think about vitamin D, dubbed the “sunshine vitamin.” While adequate amounts can be attained by spending some time with Mr. Sun, current practices including application of sunscreen and infrequent exposure to midday sun make it more difficult than you might think for children to meet these requirements. Food sources of vitamin D can make up the gap, but knowing how much and which foods to include is essential. Food allergies, intolerances or eating behaviors can make this challenging in some children. While “food first” is an excellent mantra, supplements do have application to treat and prevent deficiency.
Vitamin D requirements for children under 12 months of age are 400 International Units (IU) and older children and adolescents require 600 IU per day. A deficiency of vitamin D can lead to rickets, a bone-softening disease which is most often reported in infants under the age of two. The American Academy of Pediatrics recommends that breastfed infants receive a liquid supplement that meets the daily requirement. For infants receiving formula, 32 ounces per day is required to meet the recommended amount and supplementation should be provided if intake is below the recommended amount. A comprehensive review of vitamin D is available here.
For older children food sources of vitamin D should be included in the diet. Vitamin D is not found naturally in large amounts in many foods. The flesh of fatty fish, egg yolks and mushrooms contain high amounts of vitamin D, but may not be commonly consumed by children. Most of the foods that provide vitamin D in large amounts are fortified, and milk (whole, skim, lowfat) is the best example of fortification. Each 8 ounce serving of milk provides about 120 IU of vitamin D. Other foods such as orange juice and breakfast cereals are often fortified with vitamin D.
Determining the adequacy of vitamin D intake can be challenging as food labels are not required to list the amount of vitamin D per serving in IUs. Often, vitamin D is listed as a percentage of daily value, such as 20%. Reading food labels and considering your child’s usual intake of fortified foods can help you to determine adequacy of intake. If your child has limited food selections or does not consume foods fortified with vitamin D, consultation with a registered dietitian for a comprehensive nutrition assessment and customized plan can help to ensure adequacy of intake.
Disclaimer: Megan Boitano, MS, RDN, LDN, CNSC is a registered dietitian nutritionist. The materials and content contained on this site (meganboitano.com) are for general educational purposes only and are not intended to be a substitute for professional medical advice, diagnosis or treatment. Persons with serious medical conditions should consult a physician before beginning or modifying any diet, exercise or lifestyle program. The use of any information provided on this site is solely at your own risk.