Q: Since we are in Hawaii, does my baby still have to take vitamin D?
The AAP recommends that all children should be kept out of the direct sun as much as possible and wear sunscreen (after 6 months of age) while in the sun to avoid the long-term risk of sun exposure, which may contribute to skin cancer. Sunscreen keeps the skin from manufacturing vitamin D. For that reason, talk to your pediatrician about the need for supplemental vitamin D drops.
All infants and children should have a minimum intake of 400 IU (International Units) of vitamin D per day beginning soon after birth.
- Exclusively or partially breastfed infants: 400 IU of supplemental vitamin D daily, beginning in the first few days of life. Supplementation should continue until he or she is weaned to at least 1 qt (1 L) of whole milk per day. Whole milk should not be used until after 12 months of age.
- Formula-fed infant: All formulas sold in the United States have at least 400 IU/L of vitamin D; so if your baby is drinking at least 32 ounces of formula, vitamin D supplementation is not needed. Whole milk should not be used until after 12 months of age.
Q; What can vitamin D deficiency cause?
Rickets is a condition of softening of the bones that can occur in growing children. It happens when the bones can not take up enough calcium and phosphorus to make hard, healthy bone. Although there are genetic and metabolic causes of rickets, the most common cause is a lack of vitamin D.
Vitamin D works more like a hormone. It is a substance that the body needs to help absorb calcium from the gut and regulate how much calcium and phosphorus gets stored in the bone. Vitamin D can be obtained by eating certain types of fatty fish and fish oils, but it is also made in the skin in response to ultraviolet rays of sunlight. The use of sunscreen (which is, of course, important in preventing sunburn and skin cancer) does not allow the body to make much vitamin D in the skin. Human milk is often very low in vitamin D, especially if the mother is also deficient.
Dr. Irene Papaconstadopoulos, MD FAAP is a board-certified pediatrician at champspediatrics.com.