Four Seasons Pediatrics is on Twitter.  @fspeds

Common wisdom says that if you’re child drinks milk and plays outside, he’s getting enough vitamin D, right? Surprisingly, not necessarily.  ​We know more about vitamin D than we did even five years ago. Because of lifestyle changes and sunscreen usage, the majority of the population shows signs of vitamin D deficiency.  Vitamin D helps ensure the body absorbs and retains calcium and phosphorus, both critical for building bone. A vitamin D deficiency can lead to rickets, a bone-softening disease that continues to be reported in the United States mostly in children in the first two years of life.   Vitamin D deficiency also increases the risk of bone fractures in older children, teens, and adults.  Vitamin D is measured in International Units (IU).

The increase in the recommended amount of vitamin D children need each day is a result of new evidence showing its life-long health benefits. Supplementation is important, because most children will not get enough vitamin D through diet alone.

For a list of foods with vitamin D, click here.   See the products for supplementing Vitamin D below – along with the links posted.

What are the current recommendations for Vitamin D?

1. Breastfed infants and partially breastfed infants should be supplemented with 400 IU/day of Vitamin D until your infant is weaned to at least 18-20 ounces of vitamin fortified formula.  Supplement  with 400 IU when switching to milk at 12 months of age.  When switching to milk, we no longer recommend switching to whole milk.  All children should be on nonfat milk at age 2, and most should be on nonfat milk starting at age 1 when they switch.  The amount of Vitamin D is the same in all types of milk.  Higher fat does not confer advantages, in fact there are disadvantages.   

2. Older children (older than 12 months of age should receive 400-600 IU per day of vitamin D. 

3. Adolescents who do not obtain 600 IU of vitamin D per day through diet and vitamin D fortified foods (such as cereal and eggs) should receive a vitamin D supplement of 600 IU per day.

Here are some of the choices to supplement Vitamin D:

• Enfamil D Vi Sol – vitamins – contains vitamin D.  Contains 50 doses.  1 ml contains 400 IU of vitamin D
• Bio-D Mulsion – 1 drop contains 400 IU of vitamin D.  Contains 750 doses.  Just be careful using, there is a risk of incorrect dosing since this is very concentrated.  It is also inexpensive
• Vitamin D chewables – 1 gummi contains 600 IU
• Vitamin D capsules – 600 IU per capsule

What are the current recommendations for calcium?

How much calcium your body needs varies according to age. You need the most calcium between 9 and 18 years of age.

The American Academy of Pediatrics recommends the following daily intake of calcium:

How to get calcium

The best way to get the calcium that you need is by eating and drinking foods that naturally contain calcium. Many foods contain some calcium, but the best sources include the following:

• Low-fat milk, yogurt, and other milk products are generally super sources of calcium.
• Flavored milks, such as chocolate or strawberry, have as much calcium as plain milk but may have more calories.
• Dark green, leafy vegetables such as kale and turnip greens are low in calories and high in calcium. However, spinach is not a good source of calcium.
• Broccoli, tofu, chickpeas, lentils, split peas, and canned salmon and sardines (and other fish with bones) also are good sources of calcium.
• Calcium-fortified juices and cereals can help boost the calcium in your diet, but limit yourself to 8 to 12 ounces (1½ cups) of juice a day.