What to Know

• Learn why vitamin D is important for your baby and toddler’s health
• How much vitamin D is needed according to age
• Why vitamin D is needed from sources other than food

Vitamin D works with calcium and phosphorus to build and maintain strong bones. It is also involved in nerve transmission, neuromuscular and immune function, and is a powerful antioxidant. Vitamin D plays a critical role in both immunity and bone strength, getting too little can increase your risk of infections and limit bone development.

Other than oily fish (such as salmon, tuna, and mackerel) and fortified dairy and dairy alternatives, not many foods are high in vitamin D. This is why most of our vitamin D must come from sun exposure or supplementation. When sunlight hits our skin, it produces a hormone which then leads to the formation of vitamin D.

Your vitamin D Recommended Daily Amount varies by age:

• Infants 0 – 12 months require 400IU
• Children and adults require 600IU
• Adults 71 years and older require 800IU

Vitamin D supplementation is often necessary because it is difficult to meet the requirements from food alone and because sun exposure is not always possible or recommended. In fact, the American Academy of Pediatrics recommends supplementation for many babies and children (see below). This is particularly important for breastfed infants as breastmilk does not contain enough D to meet baby’s needs.

Supplementation is often recommended for the following groups of people who are particularly prone to deficiency:

• Breastfed infants and combination fed infants because breast milk is not a good source of vitamin D
• Formula fed infants drinking less than 32 ounces of vitamin D fortified formula per day
• Children drinking less than 32 ounces of vitamin D fortified milk
• Adolescents who do not get 600 IU of vitamin D per day in their diet
• People with a darker skin tone which produces less vitamin D from the sun
• People with fat malabsorptive conditions, such as Crohn’s disease, celiac disease or cystic fibrosis because vitamin D requires fat for proper absorption
• Those with limited access to sun exposure, including people who live in northern regions
• People who do not consume Vitamin D fortified products, such as dairy, due to allergies, intolerance or dietary choice

What to Do

Make sure your baby or child is getting enough Vitamin D, reference the above guidelines and talk to your physician about what is right for your child.

The American Academy of Pediatrics recommends that breastfed infants, and combination fed (breast milk and formula) infants should be supplemented with 400 IU of vitamin D per day beginning soon after birth.

Formula fed infants and older children (who drink less than 32 ounces of vitamin D fortified infant formula or milk per day) should be supplemented with 400 IU of vitamin D per day.

Breastfed and bottle fed infants should be given a vitamin D supplement in liquid form

Adolescents who do not get 600 IU in their diet should be supplemented with 600 IU per day

Include stage and skill food sources of vitamin D in your baby or toddler’s diet

You can find naturally occurring vitamin D in oily fish (trout, salmon and sardines), egg yolks, and shitake mushrooms.

Many other foods are fortified with vitamin D during processing, including some yogurt, cow’s milk, and dairy alternatives such as soy, almond, and rice milks, and even orange juice. Check the labels of your milk and milk alternatives, orange juice, yogurt and cereals for information on added vitamin D.

Note that juice is not recommended for babies under 1 year of age, and only 4 oz total per day are recommended for toddlers. Babies under 1 year of age should not have cow’s milk.