DEAR MAYO CLINIC: Do babies need vitamin D supplements? I have three children and am pregnant with my fourth. I've never been told until now that I should plan to give the baby vitamin D.
ANSWER: Research has shown a noticeable rise in the number of people worldwide who don't get enough vitamin D, including inthe United States. Severe vitamin D deficiency is most common in children under age 2. As a result, since 2008 theAmerican Academy of Pediatricshas recommended that all infants, children and teens have a minimum daily intake of 400 international units (IU) of vitamin D. For babies, it can be hard to get that amount of vitamin D without a supplement.
Vitamin D is important to bone and muscle health. It also plays a crucial role in the way the body absorbs calcium and phosphorus. When the body does not get enough vitamin D, it can lead to poor growth, soft or curved bones -- a condition known as nutritional rickets -- or bones that are weak and easily broken. As researchers learn more about the importance of vitamin D, it appears that the vitamin also may play a role in preventing some chronic diseases later in life.
Vitamin D comes from several natural sources, including sunshine and certain foods. In many people, some daily exposure to the midday sun without sunscreen can allow the body to make the vitamin D it needs. Relying on the sun for vitamin D is not recommended for babies and children, however, due to the risk of skin damage and skin cancer.
Vitamin D is found naturally in a few foods, such as oily fish, liver, cheese, egg yolks and some mushrooms. Many other foods are commonly enriched with vitamin D, including milk, cereal, orange juice, yogurt and margarine.
Human milk is a wonderful source of nutrition for babies. However, it does not contain all the vitamin D an infant needs. Standard infant formula is enriched with vitamin D, but babies need to drink at least 32 ounces a day to get the right amount. Babies who are either completely or partially breastfed, or who drink less than 32 ounces of formula daily, should receive 400 IU of vitamin D as a supplement each day to ensure they get enough of this important vitamin.
Vitamin D supplements come in a liquid dropper for babies. They're commonly available as a vitamin D supplement alone, as one component of a liquid multivitamin, or in a combination of vitamins A, C and D. The concentration of vitamin D varies in the different supplements, so make sure you carefully follow the manufacturer's instructions, or discuss the dose with your child's health care provider.
As your baby gets older and you add solid foods to his or her diet, you can help your baby meet the daily vitamin D requirement by providing foods that contain vitamin D. But most babies will not consistently eat these foods during their first year, so a vitamin D supplement is still recommended.
If you have unanswered questions about your baby's need for vitamin D supplements, talk to your child's health care provider. --Esther Krych, M.D., Pediatrics,Mayo Clinic,Rochester, Minn.
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